Approach To Tachycardia

Question 1

List 5 signs of hemodynamic instability

Answer 1

1. Hypotension
2. Signs of shock
3. Acute chest pain
4. Signs of heart failure
5. Acutely altered mental status

Question 2

What is the first line management of stable regular narrow complex Tachycardia.

Answer 2

Vagal stimulation

Question 3

What is the 2nd line and third line treatment of stable regular narrow complex Tachycardia?

Answer 3

Adenosine followed by amiodarone

Question 4

What is the treatment of unstable tachycardia(HR>150 BPM)

Answer 4

Synchronised DC cardioversion

Question 5

What is the immediate treatment of stable wide complex tachycardia(ventricular tachycardia)?

Answer 5

Amiodarone except for Torsades de pontes

Question 6

What is the immediate management of Torsades de pontes?

Answer 6

Asynchronous defibrillation followed by Mg

Other things to do correct electrolytes and stop offending agents.

Question 7

List 6 physiological causes of Tachycardia.

Answer 7

1. Sepsis
2. Anemia
3. Hyperthyroidism
4. Hypovolemia
5. Street drugs
6. Pain/Anxiety

Question 8

What is considered a narrow complex and wide complex tachycardia in children.and in infants?

Answer 8

Narrow
Children HR>180 and QRS<0.08s
Infants HR>220 and QRS <0.08s

Wide complex
Children:.HR>180 and QRS>0.08s
Infants: HR>200 and QRS>0.08s

Question 9

What is the initial treatment of stable irregular narrow complex Tachycardia?

Answer 9

Beta blockers or calcium channel blockers