A 63 year old man with a history of hypertension and ischaemic heart disease has been admitted to the intensive care unit with refractory hypotension due to severe sepsis. Inflammatory markers are raised and CXR has revealed a right lower and middle lobe pneumonia.
He has been intubated and ventilated and initiated on empirical antibiotics. Blood pressure has remained stable on a small dose of noradrenaline. On the ward round his heart rate is noted to be irregular and a 12 lead ECG shows new onset atrial fibrillation.
