A 48-year-old has wide-complex tachycardia at 190/min, chest pressure and BP 82/48. He is pale and diaphoretic, with a regular monomorphic rhythm on

Question

A 48-year-old has wide-complex tachycardia at 190/min, chest pressure and BP 82/48. He is pale and diaphoretic, with a regular monomorphic rhythm on the monitor. What is the most appropriate initial management?

Accepted Answer

Immediate synchronised electrical cardioversion

Answer

Adenosine followed by discharge if rhythm converts

Answer

Amiodarone infusion before any electrical therapy despite shock

Answer

Oral beta-blocker and reassessment in 2 hours

Answer

Vagal manoeuvres as definitive treatment

Unstable ventricular tachycardia — RCPSC EM MCQ

A 48-year-old has wide-complex tachycardia at 190/min, chest pressure and BP 82/48. He is pale and diaphoretic, with a regular monomorphic rhythm on the monitor. What is the most appropriate initial management?