Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first-line treatment for Stable Ventricular Tachycardia (SVT)?

1. Adenosine

2. Cardioversion

3. Vagal maneuvers

4. Beta Blocker

The correct answer is: Vagal maneuvers

The first-line treatment for stable ventricular tachycardia (SVT) typically involves vagal maneuvers. These maneuvers are non-invasive actions that can help to increase vagal tone and can effectively terminate certain types of tachycardias by slowing down conduction through the atrioventricular (AV) node. Common vagal maneuvers include the Valsalva maneuver and carotid sinus massage, both of which can trigger reflexes that affect heart rate. The rationale for choosing vagal maneuvers first is that they can often restore normal rhythm without the need for pharmacological intervention or electrical cardioversion, making them a safer option in stable patients. In the context of the other options, while adenosine can be effective for treating some types of SVT, it is usually reserved for cases where vagal maneuvers are unsuccessful. Cardioversion, which involves delivering a shock to the heart, is more appropriate for unstable patients who have significant symptoms or compromised hemodynamics. Beta blockers can be used to prevent SVT episodes but are not the first approach in an acute setting.