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Supraventricular tachycardia — RACP Paediatrics MCQ

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ModerateCardiologySupraventricular tachycardiaRACP Paediatrics

A 6-week-old has sudden pallor and poor feeding. Heart rate is 270/min, QRS complexes are narrow and regular, blood pressure is normal and capillary refill is 2 seconds. Ice to the face is attempted without effect. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Rapid intravenous adenosine with continuous ECG recording

A stable infant with narrow-complex SVT that does not terminate with vagal manoeuvres should receive rapid IV adenosine with ECG monitoring. Cardioversion is used if unstable or if pharmacological therapy fails. The pearl is that carotid massage is avoided in infants; facial ice is the safer vagal manoeuvre.

Reference: RCH Clinical Practice Guidelines: Supraventricular tachycardia; Therapeutic Guidelines (eTG)