Cardiac Arrest After Adenosine Administration in Compensatory Tachycardia: A Case Report

Compensatory tachycardia, an increased heart rate responding to stressors, requires careful consideration in treatment. This case report outlines a scenario where emergency medical services (EMS) misinterpreted a patient's electrocardiogram (EKG) as paroxysmal supraventricular tachycardia (PSVT) and administered adenosine, resulting in sudden cardiac arrest. Despite the rarity of deaths post-adenosine, this case highlights the potential risks of its use in inappropriate clinical scenarios. The patient, later diagnosed with a pulmonary embolism, had a compensatory heart rate that was disrupted after adenosine administration. While adenosine remains a safe and effective treatment for PSVT, this case report serves as a warning to EMS systems about the risks associated with its increased misuse, especially given the trends of prehospital EKG misinterpretation.