skip to main content

Regular narrow-complex tachycardia — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyAcute Cardiac PresentationsRegular narrow-complex tachycardiaSCE Acute Medicine

A 45-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 stable regular narrow-complex tachycardia at 188 per minute. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: D — Attempt vagal manoeuvres followed by adenosine if needed

The key discriminator is that stable regular narrow-complex tachycardia at 188 per minute, which makes Attempt vagal manoeuvres followed by adenosine if needed the single best answer. Arrange routine outpatient follow-up is less appropriate because it does not address the dominant acute risk in the vignette; Arrange urgent CT imaging would fit a different presentation or later stage of care. Give analgesia and antiemetic therapy and Arrange urgent specialist referral 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