A Challenging Case of SVT

Author: Gavin Lloyd / Editor: Steve Fordham / Reviewer: Michael Perry / Codes: A1Published: 15/03/2019

A 26-year-old woman presents to the ED with one hour of palpitations associated with light-headedness and shortness of breath. She has a recent history of such symptoms, for which no cause has been found. Her palpitations normally cease after ten or so minutes. A GP has prescribed atenolol 25 mg daily and she has been taking this for the last couple of weeks. She is otherwise in good health.

At presentation she is relatively well: HR 190, BP 100/70, RR 24 and sats 100% on air. Her clinical examination is unremarkable. Her ECG is as demonstrated.

You diagnose a narrow complex tachycardia/SVT. She fails to respond to vagal manoeuvres. Further, there is no response to 6 or 12 mg of adenosine.

A challenging case of SVT SAQ 1

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