Narrow Tachycardia

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1

What is the next step in management?

During an ACLS training, a patient with narrow complex tachycardia fails to respond to two doses of adenosine.

Hint: Think about the intervention after failed medication therapy.
2

What is the most appropriate initial treatment?

 A 55-year-old patient presents with a heart rate of 180 bpm and narrow QRS complexes on the ECG. The patient is hemodynamically stable but complains of mild chest discomfort.

Hint: Before immediate synchronization is utilized, medication is recommended.
3

What is the likely underlying rhythm?

A 35-year-old female experiences palpitations and is found to have a narrow complex tachycardia on ECG. After administering adenosine, her heart rate returns to normal.

Hint: Adenosine is not primarily indicated in Atrial Fibrillation, especially with a rapid ventricular rate.
4

What is the next best step?

During an ACLS scenario, a patient with a narrow complex tachycardia suddenly becomes hypotensive.

Hint: Calcium channel blockers would be contraindicated due to its blood pressure lowering capability..
5

Which medication should be avoided?

A patient with a history of Wolff-Parkinson-White (WPW) syndrome presents with narrow complex tachycardia at 190 bpm.

Hint: Calcium channel blockers are contraindicated in patient's with WPW history.
6

What is the most likely diagnosis?

A 70-year-old male with a narrow complex tachycardia is not responsive to adenosine. The ECG shows SVT with a rate of 160 bpm.

Hint: Adenosine is not indicated in Normal Sinus Rhythm.
7

Which rhythm is the patient most likely in?

In the ER, a patient with narrow complex tachycardia has a history of COPD. The ECG shows an irregular rhythm.

Hint: Thyroid disease and underlying cardiac disease is a common cause of atrial flutter.
8

What is the next recommended action?

A patient presents with dizziness and a narrow complex tachycardia of 210 bpm. Vagal maneuvers fail to convert the rhythm.

Hint: This intervention is done before synchronized cardioversion.
9

Which medication should be considered carefully due to the patient's condition?

A patient with a narrow complex tachycardia and a known history of heart failure presents to the ER.

Hint: Consider the calcium channel blocker that has a negative inotropic effect, thereby, worsening heart failure.
10

What is the long term treatment for this condition if all other interventions fail?

A 40-year-old male presents with a history of palpitations and is diagnosed with AVRT.

Hint: Adenosine is not considered long term.

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