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Paroxysmal supraventricular tachycardia — RCPSC EM MCQ

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HardCardiovascular emergenciesParoxysmal supraventricular tachycardiaRCPSC EM

A 24-year-old woman has sudden palpitations. ECG shows a regular narrow-complex tachycardia at 190/min. She is anxious but blood pressure is 118/74 mmHg and there is no chest pain or heart failure. What is the most appropriate next step?

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Correct answer: B — Use modified Valsalva manoeuvre, then adenosine if vagal manoeuvres fail

Stable regular narrow-complex tachycardia is usually treated first with vagal manoeuvres, particularly modified Valsalva, followed by adenosine when needed. Cardioversion is for instability or refractory cases.

Reference: ACLS; Canadian dysrhythmia emergency practice