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Monomorphic ventricular tachycardia — SCE Acute Medicine MCQ

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ModerateAcute Cardiac PresentationsMonomorphic ventricular tachycardiaSCE Acute Medicine

A 71-year-old woman presents with acute chest symptoms with haemodynamic concern. Relevant history includes cardiovascular risk factors or structural heart disease. On assessment, haemodynamic findings and ECG changes are present. Investigations show regular broad-complex tachycardia occurs in a patient with prior MI. What is the most appropriate next step in management?

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Correct answer: D — Treat as ventricular tachycardia and consider synchronised cardioversion

The key discriminator is that regular broad-complex tachycardia occurs in a patient with prior MI, which makes Treat as ventricular tachycardia and consider synchronised cardioversion the single best answer. Give analgesia and antiemetic therapy is less appropriate because it does not address the dominant acute risk in the vignette; Start anticoagulation after assessing bleeding risk would fit a different presentation or later stage of care. Start broad-spectrum intravenous antibiotics and Call critical care for escalation are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: Resuscitation Council UK ALS