Wide Complex Tachycardias

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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

HPI: 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…

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: 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…

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…

ECG cases to help you save lives and also crush your board exams

A 45-year-old woman is being observed in the emergency department after treatment with thrombolytics for MI. She is noted to be tachycardic one hour after treatment with a change in…

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

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…

Wide Complex Tachycardias: what you gotta know about the two major types of polymorphic ventricular tachycardia

A 66-year-old female with a history of substance abuse on methadone is brought to the ED for syncope and altered mental status. She is altered and agitated on arrival and…

STAT ECG Diagnoses: using the ECG in cases of wide complex tachycardia to diagnose ventricular tachycardia (VT)

A 25-year-old otherwise healthy woman with no significant PMHx presents to the ED with palpitations. The following ECG was obtained:

STAT ECG Diagnoses: ventricular fibrillation after synchronized cardioversion for a regular wide complex tachycardia

A 50-year-old male is brought into the ED with palpitations and is found to have a regular wide complex tachycardia. He is treated with synchronized electrical cardioversion and immediately goes…

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

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…

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