Differential Diagnoses: what you gotta know about regular wide complex tachycardias

ECG Weekly Workout with Dr. Amal Mattu


A 72-year-old woman is brought into the emergency department by family for confusion. She has a history of abdominal hernia repair with subsequent complications, including an exploratory laparotomy for an anastomotic leak 10 days ago. She is noted to be hypotensive (76/31), tachycardic (HR fluctuating between 140-150 bpm), with altered mental status on arrival. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself:

  1. What is your differential for regular wide complex tachycardias?
  2. What is the most likely diagnosis?
  3. How would you manage this case?