ECG Quiz: 56-year-old female patient: Dyspnea + pressing chest pain

History

1. Symptoms: Paresthesias in the left arm
2. Past medical history: Hypothyroidism
3. Vital signs: Pulse 140/min, BP 160/110, SpO₂ 94 %
4. Important note: Propranolol forgotten

Quiz

1. Which arrhythmia is most likely on the ECG?
2. Which intervention should be performed first in a hemodynamically stable female patient?
3. Please explain how you would correctly perform a vagal maneuver in this patient.
4. The vagal maneuvers remain unsuccessful. Which medication is now the first-line agent?
5. After successful termination of the tachycardia, recurrence should be prevented. Which therapy is most appropriate to prevent recurrence?
6. In which finding would an immediate synchronized electrical cardioversion be indicated instead of vagal maneuvers and adenosine?

AVNRT

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