Image Based Question – 74507

A 52 years old diabetic male presents with palpitations to the AIIMS emergency. On examination, the systolic blood pressure was 70 mm Hg. The following was his ECG recorded in emergency. What is the immediate next step in management?

A. Electrical cardioversion

B. Amiodarone

C. Adenosine

D. Immediate PCI

Correct Answer » A Explanation

Ans: A. Electrical cardioversion 

(Ref: Harrison 19/e p1483-1484, 1479 18/e p1888)

• The given ECG shows tachycardia with narrow QRS complex and absent P waves, the diagnosis is Paroxysmal Supraventricular Tachycardia (PSVT).
• Since the patient is in shock with hypotension, electrical cardioversion is the immediate treatment of choice.
• Drug of choice for PSVT is Adenosine hut it is to he used hemodynamically stable patients.