Emergency Medical Technician (EMT) Intermediate Practice Exam

Which clinical presentation is indicative of a malfunctioning implanted pacemaker?

1. Hypotension and tachycardia

2. Syncope and bradycardia

3. Persistent chest pain

4. Severe headache and dizziness

The correct answer is: Syncope and bradycardia

The indication of a malfunctioning implanted pacemaker is typically characterized by bradycardia and syncope. An implanted pacemaker is designed to regulate the heart's rhythm, especially in patients with conditions like bradycardia, where the heart beats too slowly. When the pacemaker is malfunctioning, it may fail to deliver the necessary electrical impulses, resulting in a slower heart rate (bradycardia) than the patient requires. Syncope, or fainting, can occur due to insufficient blood flow to the brain, which is likely if the heart is not beating effectively or fast enough to meet the body's needs. Consequently, patients might experience a sudden loss of consciousness. This combination of bradycardia and syncope is a clear sign that the pacemaker is not functioning as intended. Other options present different clinical presentations that are not directly linked to pacemaker malfunction. Hypotension and tachycardia could indicate various issues but are not specifically tied to a pacemaker failure. Persistent chest pain can suggest many cardiac complications but does not imply malfunctioning of the pacemaker specifically. Severe headache and dizziness might relate more to neurological issues or other cardiovascular problems, but again, are not associated with pacemaker function.