A 28-year-old woman presents to an Adelaide ED, triage category 1, with palpitations and syncope. BP 72/40, HR 210 regular narrow-complex

Question

A 28-year-old woman presents to an Adelaide ED, triage category 1, with palpitations and syncope. BP 72/40, HR 210 regular narrow-complex tachycardia, RR 24, SpO2 98% on oxygen. She is pale, confused and has no chest pain history. What is the most important immediate action?

Accepted Answer

Perform synchronised electrical cardioversion

Answer

Observe during vagal manoeuvres

Answer

Administer IV magnesium sulphate

Answer

Arrange outpatient Holter monitoring

Answer

Give oral metoprolol

Unstable supraventricular tachycardia — ACEM Fellowship MCQ

A 28-year-old woman presents to an Adelaide ED, triage category 1, with palpitations and syncope. BP 72/40, HR 210 regular narrow-complex tachycardia, RR 24, SpO2 98% on oxygen. She is pale, confused and has no chest pain history. What is the most important immediate action?