What is the immediate treatment approach if a patient experiences slow heart rate and symptoms with a second-degree type 2 AV block?

In the context of a second-degree type 2 atrioventricular (AV) block, particularly when the patient exhibits bradycardia along with symptoms such as dizziness, fatigue, or syncope, immediate treatment is crucial to stabilize the patient. The preferred approach in this situation is the administration of atropine.

Atropine is an anticholinergic medication that works by blocking the effects of the vagus nerve on the heart, thereby increasing the heart rate by inhibiting the parasympathetic stimulation. In cases where the patient is symptomatic due to a slow heart rate, such as with a second-degree type 2 AV block, atropine can provide rapid relief of bradycardia and help restore normal hemodynamics.

In contrast, intravenous fluids, while important in other scenarios such as hypovolemia or dehydration, do not directly address the underlying conduction issue that is causing the slow heart rate in AV block. A stress test is inappropriate in an acute setting where the patient is symptomatic and requires immediate cardiac rate management. Defibrillation is indicated primarily for life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia, not for bradyarrhythmias like a second-degree type 2