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Stable supraventricular tachycardia — DipIMC MCQ

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ModerateMedical EmergenciesStable supraventricular tachycardiaDipIMC

A 22-year-old man has palpitations with a regular narrow-complex tachycardia at 190 bpm. He is alert, blood pressure is 122/78 and there is no chest pain or heart failure. What is the most appropriate immediate action?

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Correct answer: D — Attempt vagal manoeuvres while monitoring and preparing escalation

A stable regular narrow-complex tachycardia should initially be managed with vagal manoeuvres and monitoring, with adenosine considered if unsuccessful and within scope. Unsynchronised shocks are for pulseless shockable rhythms, while synchronised cardioversion is for instability. Tachycardia rate alone does not mean cardiac arrest. The pearl is that stability determines urgency and electrical strategy.

Reference: Resuscitation Council UK Adult ALS Guidelines 2025; JRCALC Guidelines 2025