Question:
A hemodynamically unstable patient presents with supraventricular tachycardia (SVT) as shown.
The most appropriate immediate management is:
A hemodynamically unstable patient presents with supraventricular tachycardia (SVT) as shown.
The most appropriate immediate management is:
The most appropriate immediate management is:
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When the patient is unstable, electricity beats drugs.
Updated On: Jun 23, 2026
- IV ibutilide
- IV diltiazem
- Cardioversion
- IV beta-blockers
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The Correct Option is C
Solution and Explanation
Step 1: The defining feature is hemodynamic instability (hypotension, altered sensorium, ischemic chest pain or signs of shock) in a patient with SVT.
Step 2: Per ACLS, any tachyarrhythmia with serious signs of instability is treated with immediate synchronised electrical cardioversion, regardless of the specific rhythm.
Step 3: Drugs such as diltiazem, beta-blockers and ibutilide act too slowly and can further drop the blood pressure in an unstable patient, so they are reserved for the stable patient.
Conclusion: The unstable SVT patient needs immediate synchronised cardioversion.
Ref: ACLS Guidelines.
Step 2: Per ACLS, any tachyarrhythmia with serious signs of instability is treated with immediate synchronised electrical cardioversion, regardless of the specific rhythm.
Step 3: Drugs such as diltiazem, beta-blockers and ibutilide act too slowly and can further drop the blood pressure in an unstable patient, so they are reserved for the stable patient.
Conclusion: The unstable SVT patient needs immediate synchronised cardioversion.
Ref: ACLS Guidelines.
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