MCQ Pediatric Cardiology Answer 14

The Correct Answer is C


This patient has supraventricular tachycardia. The rhythm is rapid and regular and no P-waves are evident. The patient is hemodynamically stable with no angina or evidence of heart failure, so emergency cardioversion is not indicated, nor would attempts to insert a pacemaker for this arrhythmia be indicated at this time. Neither bretylium nor lidocaine is likely to terminate this arrhythmia; the drug of choice would be adenosine, verapamil, or a ß-blocker.


This EKG could be interpreted as atrial flutter with 2:1 block, in which case the initial treatment in a hemodynamically stable patient would be vertricular rate control with a ß-blocker, calcium antagonist, or digitalis. Immediate treatment with adenosine would not be effective, but would not be harmful and could clarify the underlying rhythm disturbance.


Ref: 1) Braunwald E, Fauci AS, Kasper DL, et al (eds): Harrison’s Principles of Internal Medicine, ed 15. McGraw-Hill, 2001, p 1299. 2) Goldberger: Clinical Electrocardiography: A Simplified Approach, 6th ed. (ABFM, 2002).

Category: Pediatrics MCQs