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Supraventricular tachycardia stable — SCE Acute Medicine MCQ

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EasyAcute Cardiac PresentationsSupraventricular tachycardia stableSCE Acute Medicine

A 44-year-old woman is assessed on the acute medical unit. She has regular narrow-complex tachycardia at 176/min, normal blood pressure and no chest pain. The rhythm started suddenly during exercise. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: D — Attempt vagal manoeuvres with continuous monitoring

Attempt vagal manoeuvres with continuous monitoring is the best answer because stable regular narrow-complex tachycardia is initially treated with vagal manoeuvres before adenosine. Start therapeutic anticoagulation while awaiting imaging is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Check for adverse features before choosing electrical treatment.

Reference: Resuscitation Council UK ALS