Then he develops a sudden onset of dyspnea. His pulse is 130 per minute and irregular. Electrocardiography shows atrial fibrillation.
Chest radiography shows bilateral diffuse interstitial infiltrates.
Amiodarone is not a good choice for this patient as he has left ventricular dysfunction. Amiodarone is commonly used for refractory atrial fibrillation. The dyspnea and chest radiograph picture indicate that this patient has pulmonary toxcicity from amiodarone. The recurrence of atrial fibrillation in this patient with coronary artery disease is because of the proarrhythmic effect of amiodarone. TSH should be periodically checked in patients on amiodarone to pick up hypothyroidism.