Wide Complex Tachycardias

Optical Illusions and 12-Lead ECGs: How First Impressions Can Mislead

A 42-year-old woman presents to the emergency department with chest pain, shortness of breath, and palpitations. Her blood pressure and mental status are noted to be normal. The following ECG…

Unrecognized Killers in Emergency Electrocardiography, Part II

A 46-year-old woman presents after two syncopal episodes associated with palpitations. She reports feeling a rapid heart rate before losing consciousness. She has a few witnessed episodes in the emergency…

Unrecognized Killers in Emergency Electrocardiography

A 42-year-old man presents with fever, cough, shortness of breath, and vomiting. He appears toxic and dehydrated on arrival with suspected severe sepsis from multilobar pneumonia. He is later intubated…

2025 EMS Cases Part III

A 69-year-old woman is being brought in by EMS for palpitations and dizziness. She is found to be markedly tachycardic, but is alert with a normal blood pressure. The following…

How the Lewis Lead Can Improve Tachyarrhythmia Diagnosis

A 68-year-old woman presents to the emergency department with palpitations and tachycardia. The following ECG is obtained:

2024 EMS Cases Part IV

A 60-year-old man is being transported by EMS to the emergency department for acute chest pain. The following ECG is transmitted prior to arrival as a “CODE STEMI” and brought…

Wolff-Parkinson-White (WPW) Syndrome with Atrial Fibrillation (Afib)

A 53-year-old man presents to the emergency department with palpitations and lightheadedness. On arrival, he is found to have a wide complex tachycardia and the following ECGs is obtained:

Wolff-Parkinson-White (WPW) Syndrome with Supraventricular Tachycardia (SVT)

A 24-year-old man with past medical history of WPW syndrome s/p ablation presents to the emergency department with palpitations. On arrival, he is found to have a wide complex tachycardia…

Runs of ventricular tachycardia vs. another phenomenon

A 33-year-old man with a past medical history of atrial fibrillation years ago presents with anxiety and shortness of breath. His blood pressure is normal on arrival but he is…

2024 EMS Cases Part II

A 56-year-old woman is being brought in by EMS for palpitations. The following EMS ECG is obtained and transmitted:

Wide Complex Tachycardias: clues to VT mimics when the heart rate is too slow or the QRS complexes are too wide

An unknown aged female is being transported to the emergency department by EMS for altered mental status. She is agitated and slurring words. Vitals: 98/65, RR 24, HR 162.  The…

Wide Complex Tachycardias: beware the many mimics of ventricular tachycardia

A 73-year-old woman with PMHx of HTN, DM, HLD presents to the emergency department with 2 days of vomiting, malaise, and indigestion with chest discomfort. The following ECG is obtained:

Wide Complex Tachycardias: using modified ECG leads to distinguish ventricular tachycardia from supraventricular tachycardias (VT vs. SVT)

A 60-year-old man presents to the emergency department with left sided chest pain and lower extremity edema. Initial vitals: HR= 155, BP = 120/96, RR = 22, SpO2 = 90%,…

Wide Complex Tachycardias: does response to Valsalva maneuvers or adenosine rule out ventricular tachycardia?

Wide Complex Tachycardias: can ECG algorithms safely rule out ventricular tachycardia in the emergency department?

A 45-year-old man with PMHx of hypertension, obesity, and tobacco use presents to the ED with palpitations. Symptoms have been intermittent throughout the day with an associated episode of syncope….

Wide Complex Tachycardias: differentiation between the four different types of ventricular tachycardia & the importance of recognizing arrhythmias in tachy-brady syndromes

A 73-year-old woman is found by family in bed with decreased level of consciousness. She is brought into the ED for evaluation and is found to have bradycardia and episodic…

Wide Complex Tachycardias: review of ventricular rhythms, benign and malignant

A 52-year-old man with PMHx of diabetes presents to the emergency department with chest pain, nausea, vomiting, and cough. He is found to be tachycardic at triage. The following ECG…

Differential Diagnoses: must know causes of right axis deviation and wide QRS complexes

A 30-year-old man is pulled over by police for speeding. He begins feeling nauseous and has multiple episodes of vomiting. During transport to the emergency department by EMS he is…

Wide Complex Tachycardias: using old ECGs, Lewis leads, and rabbit ears to distinguish VT from SVT

A 48-year-old woman presents to the emergency department with palpitations. She is noted to be tachycardic at triage. The following ECG is obtained:

Wide Complex Tachycardias: distinguishing malignant arrhythmias from their mimics

A 65-year-old woman with PMHx of Parkinson’s disease presents to the emergency department after an episode of syncope. She continues to feel unwell on arrival and appears diaphoretic, blood pressure…