Wide Complex Tachycardias: considerations in unstable patients with discussion on an important VT mimic

ECG Weekly Workout with Dr. Amal Mattu


A 78-year-old woman called EMS for palpitations and mild chest pressure. She was shocked 4 times prior to arrival for a wide complex tachycardia and waxing and waning mental status without success. The following ECG is obtained on arrival to the ED:

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

  1. What ECG abnormalities do you notice?
  2. What’s the most likely diagnosis?
  3. What is the next best step in management?