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Wolff-Parkinson-White with AF — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsWolff-Parkinson-White with AFSCE Acute Medicine

A 32-year-old man is assessed on the acute medical unit. He has irregular broad-complex tachycardia at 210/min and known pre-excitation. Blood pressure is maintained but he is very symptomatic. 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: E — Avoid AV-nodal blockers and seek urgent cardiology advice

Avoid AV-nodal blockers and seek urgent cardiology advice is the best answer because pre-excited AF can deteriorate with AV-nodal blockers and needs specialist rhythm-control strategy. Arrange urgent CT imaging before treatment 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: Irregular broad-complex tachycardia is not treated as ordinary AF.

Reference: ESC SVT guideline