With only limited experience of emergency medicine, one could be forgiven for thinking that SVT is a ‘no brainer’ – a harmless condition of the young simply requiring a bolus of adenosine then discharge home. This is untrue, and several pitfalls await those doctors who combine inexperience with over confidence.

SVT can occur at all ages and is usually, but not always, well tolerated by the patient. In younger patients SVT may cause only a nuisance palpitation and anxiety, however rates above 150, and pre-existing cardiac disease or other co-morbidity greatly increase the likelihood of symptoms such as ischaemic chest pain, dizziness, syncope or breathlessness.

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