65-Year-Old Patient Presenting With Seizure
A 65-year-old man presented with shakiness and transient loss of consciousness. On arrival to the emergency department, his blood pressure and heart rate in supine position were 154/84 mmHg and 101 bpm, respectively; 3 minutes after standing up, his blood pressure and heart rate were 162/91 mmHg and 102 bpm, respectively. The patient's wife, who witnessed the episode, reported that the patient's eyes suddenly rolled back before he started shaking and then lost consciousness for 30 seconds. The patient was instantly oriented after regaining consciousness. She reported similar episodes during the month, prior to admission, that were associated with cough spells. A neurological exam did not reveal any deficits, and the cardiopulmonary exam was unremarkable. The patient was newly diagnosed with lung adenocarcinoma 3 weeks prior to presentation following intractable episodes of dry cough and low-grade fevers. The patient was recently started on radiation and chemotherapy regimen, including carboplatin, pemetrexed, erlotinib, and prochlorperazine. Magnetic resonance imaging of the brain was negative for metastasis. The patient's electrocardiogram (ECG) is shown in Figure 1.
What's the most appropriate next step in management?