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SLO3 ยท ResuscitationCardiology
โฑ Q142 / 180

A 68-year-old man presents with palpitations. ECG shows a regular broad-complex tachycardia at 180 bpm. He is alert, BP 104/68 mmHg, no chest pain, with a history of ischaemic heart disease. Most appropriate initial management?

AIV adenosine 6 mg rapid bolus
BIV amiodarone 300 mg over 20โ€“60 min
CImmediate synchronised DC cardioversion
DIV verapamil 5 mg
EVagal manoeuvres
Explanation

B is correct. A regular broad-complex tachycardia with a history of IHD is ventricular tachycardia until proven otherwise. As he is stable with no adverse features, the Resus Council (UK) algorithm recommends IV amiodarone 300 mg. Verapamil (D) is contraindicated in VT.

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