We’ve all seen it: that classic monitor alarm sound that makes your soul briefly leave your body — “Ventricular Tachycardia (VT)”.
Is it monomorphic? Polymorphic? Stable? Unstable?
The heart’s throwing a tantrum, and you are expected to calm it down before it flatlines into a silence none of us want. 😬
I still remember a night shift at Sheikh Khalifa Bin Zayed Hospital, Quetta — patient in the CCU suddenly goes into VT on the monitor, nurse yells “Doctor sahib!” like we’re in an ER episode, and I nearly perform synchronized cardioversion on myself. But we stabilized him — thanks to the mnemonic that’s now burned into my hippocampus:
🐑 “LAMB” Mnemonic – Ventricular Tachycardia Treatment Simplified
| Letter | Drug/Treatment | Clinical Use |
|---|---|---|
| L | Lidocaine | Class Ib antiarrhythmic, great for ischemia-related VT (post-MI etc.) |
| A | Amiodarone | Broad-spectrum antiarrhythmic, first-line in stable monomorphic VT |
| M | Mexiletine / Magnesium | Mexiletine = oral lidocaine cousin (chronic VT); Magnesium = for Torsades |
| B | Beta-blockers / BANG! (DC cardioversion) | Beta-blockers in chronic VT or congenital syndromes; Shock if unstable ⚡ |
👨⚕️ Real Talk from the CCU
In our unit, I’ve had patients come in post-MI, suddenly flip into monomorphic VT, BP stable but rapidly dropping. Start Amiodarone IV, prepare for shock. If it’s polymorphic, check electrolytes fast — low Mg or K is often the silent culprit.
One night, a patient was flipping between sinus and Torsades — a magnesium bolus saved us both from another ECG-induced panic attack.
If you’re managing VT and don’t know where to start, just follow the LAMB 🐑 — and don’t forget to check for pulse, stability, and electrolytes. VT can escalate fast, but with a systematic approach (and a bit of cardiac zen), you can turn chaos into sinus rhythm.
Happy learning, folks! 🙂
✍️ Written by
Dr. Aurangzaib Qambrani
MBBS, PLAB, MRCP-UK
General Medicine | Gastroenterology | Cardiac Care Unit
Sheikh Khalifa Bin Zayed Hospital, Quetta
