Author: Jidhin Davis / Editor: Jessie Lynch / Codes: / Published: 24/07/2024
A 29-year-old woman presents to the Emergency Department (ED) with one hour of palpitations associated with light-headedness. She has a recent history of such symptoms, for which no cause has been found. Her palpitations normally cease spontaneously after ten minutes or so. 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 her vital signs are: heart rate 190, blood pressure 100/70, respiratory rate 24 and oxygen saturation 100% on air. Her clinical examination is unremarkable. Her ECG is as demonstrated.
You diagnose a narrow complex tachycardia. She fails to respond to vagal manoeuvres. Further, there is no response to 6 or 12 mg of adenosine.
