STAT ECG Diagnoses: ventricular tachycardia mimics in patients with ST segment elevation

ECG Weekly Workout with Dr. Amal Mattu


A 30-year-old woman calls 911 for chest discomfort, shortness of breath, and a rapid heart rate. On arrival, medics find her tachycardic and tachypneic with a normal blood pressure. The following prehospital ECG is transmitted to the ED, and they ask for recommendations on initiating treatment of this wide complex tachycardia: 

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 cause of this wide complex rhythm?
  3. What recommendations would you give to EMS prior to arrival?