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Unstable tachyarrhythmia — DIPIMC MCQ

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ModerateResuscitationUnstable tachyarrhythmiaDIPIMCDipIMC

A patient has a broad-complex tachycardia at a rate of 190. He has chest pain, a blood pressure of 78/40 and is clammy and unwell.

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Correct answer: D — Perform synchronised direct current cardioversion.

A tachyarrhythmia with adverse features such as hypotension, chest pain and shock requires immediate synchronised cardioversion rather than pharmacological control. Adenosine and vagal manoeuvres are for stable narrow-complex tachycardias. Delaying for a drug infusion risks deterioration to cardiac arrest.

Reference: Resuscitation Council UK Guidelines (2025)