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Ventricular Tachycardia — RACP Adult Medicine MCQ

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HardCardiologyVentricular TachycardiaRACP Adult Medicine

A 70-year-old with prior anterior myocardial infarction has a regular broad-complex tachycardia at 185/min with AV dissociation. He is pale, confused and has systolic pressure 72 mmHg. What is the immediate rhythm treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: DPerform synchronised cardioversion now while continuing resuscitative support

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · A = shown as D · B = shown as E

A is correct. Shock and altered consciousness make this unstable ventricular tachycardia, requiring immediate synchronised cardioversion. B may be considered only in stable, regular monomorphic broad-complex tachycardia when SVT with aberrancy remains possible. C delays definitive treatment. D can worsen shock and misreads AV dissociation. E is inappropriate for unstable VT.

Reference: ANZCOR, Guideline 11.9: Managing acute dysrhythmias: https://www.anzcor.org/home/advanced-life-support/guideline-11-9-managing-acute-dysrhythmias/