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Stable broad-complex tachycardia — SCE Acute Medicine MCQ

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HardCardiovascular medicineStable broad-complex tachycardiaSCE Acute Medicine

A 68-year-old man with heart failure is admitted after collapse. ECG shows broad-complex tachycardia at 178/min. BP is 118/74 mmHg, he is alert and has no chest pain or pulmonary oedema. There is a history of previous myocardial infarction. What is the most appropriate next step in management?

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Correct answer: A — Treat as ventricular tachycardia and give intravenous amiodarone with expert support

A regular broad-complex tachycardia in a patient with structural heart disease should be treated as VT unless proved otherwise. If stable, IV amiodarone or procainamide with expert support is appropriate; if adverse features develop, synchronised cardioversion is needed. Verapamil can cause cardiovascular collapse in VT.

Reference: Resuscitation Council UK ALS 2025