A 7-year-old child is found incidentally to have a narrow complex tachycardia at 230 bpm with no P waves visible. He is haemodynamically stable. What is the first-line pharmacological treatment?
- A IV digoxin 10 mcg/kg loading dose
- B IV adenosine 0.1 mg/kg rapid bolus ✓
- C IV amiodarone 5 mg/kg over 20 minutes
- D IV verapamil 0.1 mg/kg
Correct answer: B. IV adenosine 0.1 mg/kg rapid bolus
Explanation
Supraventricular tachycardia (SVT) in a haemodynamically stable child is initially treated with vagal manoeuvres; if unsuccessful, IV adenosine 0.1 mg/kg (max first dose 6 mg) as a rapid bolus is the first-line pharmacological treatment. Adenosine temporarily blocks AV node conduction and terminates re-entrant SVT. Verapamil is avoided in children under 1 year and used cautiously in infants due to risk of cardiovascular collapse. Amiodarone is reserved for amiodarone-sensitive SVTs or haemodynamically unstable cases.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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