STAT ECG Diagnoses: the great immitator strikes again in a case of wide complex tachycardia

ECG Weekly Workout with Dr. Amal Mattu


A 48-year-old female presents to the ED 2 days after Thanksgiving with complaints of severe generalized weakness, palpitations, and chest discomfort. She is noted to be tachycardic and tachypneic at triage with a blood pressure of 105/60. The following ECG is obtained:

Case 263

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the most likely cause of the wide complex tachycardia seen?
  3. What would your initial management choice be?