SVT (Supraventricular Tachycardia)

Supraventricular tachycardia (SVT) is a serious arrhythmia characterized by abnormally rapid heartbeats originating above the heart’s ventricles. This condition can lead to symptoms such as palpitations, dizziness, and in severe cases, cardiac arrest. This practice paper focuses on ACLS megacode simulation exercises designed to enhance your ability to recognize and manage SVT. Participate and be prepared to handle emergencies involving supraventricular tachycardia.

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1

What is the most likely diagnosis?

A 45-year-old woman presents to the emergency room with a sudden onset of palpitations, dizziness, and mild chest discomfort. Her ECG shows a regular, narrow QRS complex tachycardia at 160 bpm.

Hint: Look for the characteristics of the QRS complex and heart rate.
2

What is the first-line treatment for this patient?

A 30-year-old male arrives at the ER with palpitations and shortness of breath. He is found to be hemodynamically stable with a heart rate of 180 bpm.

Hint: The treatment often involves an agent that can quickly reverse SV
3

What is the mechanism of action of adenosine in treating SVT?

A 50-year-old patient presents with palpitations and light-headedness. His ECG shows SVT, and adenosine is administered, leading to normalization of his heart rate.

Hint: Consider the drug's effect on AV nodal conduction.
4

Which long-term treatment option may be considered to prevent recurrent episodes?

A 35-year-old woman experiences recurrent episodes of SVT despite initial treatment with adenosine.

Hint: Think about medications that can prevent the recurrence of arrhythmias.
5

What is a non-pharmacologic treatment option for recurrent SVT?

A 40-year-old man with recurrent SVT asks about non-pharmacologic treatment options.

Hint: Consider a definitive treatment that targets the arrhythmia source.
6

Which diagnostic tool can help confirm the diagnosis of SVT?

A 28-year-old female presents to the clinic with frequent episodes of palpitations lasting for several minutes each time.

Hint: Consider a tool that records heart activity over an extended period.
7

What is the most appropriate immediate action?

A 55-year-old man presents with severe palpitations and syncope. His ECG shows SVT, and he is hemodynamically unstable.

Hint: Consider the treatment for an unstable patient with SVT.
8

What might be a side effect of beta-blocker therapy?

A 60-year-old patient with a history of SVT is on beta-blocker therapy but presents with symptoms of fatigue and bradycardia.

Hint: Consider the effects of beta-blockers on heart rate.
9

What nonpharmacologic maneuver can be attempted first to detect her SVT?

A 50-year-old female with no prior history of heart disease experiences sudden palpitations and an ECG shows SVT. She is hemodynamically stable.

Hint: Consider maneuvers that increase vagal tone.
10

What lifestyle modification might help prevent future episodes?

A 25-year-old athlete experiences palpitations during intense exercise, and his ECG shows SVT.

Hint: Consider factors that can trigger arrhythmias.

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