The Wide Complex Rhythm That Fooled Everyone
ECG Weekly Workout with Dr. Amal Mattu
HPI
A 30-year-old woman presents with one hour of chest discomfort and palpitations. On arrival she is borderline but not frankly unstable. The 12-lead shows a fast rhythm that appears wide at first glance. Cardiology and then EP are consulted and label it VT. Multiple cardioversions and adenosine are given without effect. The patient decompensates, is intubated, and progresses to cardiac arrest with unsuccessful resuscitation.
Before watching this week’s workout, review the arrival ECG carefully and consider:
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- How would you have managed this differently?
- What diagnosis was missed?
- What ECG findings here should make you doubt VT?
