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HardEmergencyUnstable supraventricular tachycardiaau-amcau-acem

A 23-year-old man presents to ED after collapsing during exercise. He is pale and hypotensive with HR 130 bpm. ECG shows narrow complex tachycardia at 180 bpm consistent with supraventricular tachycardia (SVT). He is conscious but signs of shock are present. What is the most appropriate immediate management?

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