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Supraventricular tachycardia — MRCPCH FOP MCQ

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HardCardiologySupraventricular tachycardiaMRCPCH FOP

A 6-week-old infant is pale and feeding poorly. Heart rate is 270/min with narrow-complex tachycardia on ECG, capillary refill is 4 seconds and blood pressure is low for age. What is the most appropriate management?

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Correct answer: A — Synchronised DC cardioversion

The infant has supraventricular tachycardia with cardiovascular compromise, so synchronised cardioversion is required. Adenosine is appropriate for stable narrow-complex SVT but should not delay cardioversion in shock. Furosemide does not treat the arrhythmia and may worsen perfusion. The pearl is that babies with SVT may present with poor feeding rather than palpitations.

Reference: Resuscitation Council UK APLS; BNFc Adenosine