A 35 year-old woman presents the ED with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or lightheadedness. Which of the following is indicated first?
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give metoprolol 5 mg IV and repeat if necessary
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perform vagal maneuvers
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give adenosine 3 mg IV fast
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give adenosine 12 mg IV slow push (over 1-2 mins)
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