Wide Complex Tachycardias
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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…
STAT ECG Diagnoses: what exactly is Ashman phenomenon and why does it matter?
A 50-year-old male with PMHx of atrial fibrillation presents to the ED with palpitations. He is found to be tachycardic, and while being treated for suspected atrial fibrillation with RVR,…
Differential Diagnoses: what to consider in patients with regular wide complex tachycardias (RWCT)
A 45-year-old male presents to the ED with palpitations and is found to be markedly tachycardic. The following ECG is obtained:
STAT ECG Diagnoses: intermittent runs of nonsustained ventricular tachycardia vs. aberrant conduction
A 36-year-old male with PMHx of RV failure, pulmonary hypertension, and HFrEF presents to the ED with shortness of breath, palpitations, and cough. The following ECG is obtained:
STAT ECG Diagnoses: a review of the differentials to consider when dealing with wide complex tachycardias and when antiarrhythmic medications can be harmful
A 41-year-old female is brought into the ED by EMS unresponsive with unknown past medical history. She is found to be febrile, normotensive (126/78), tachycardic (120s-150s), tachypneic (30s with a…
STAT ECG Diagnoses: knowing what you are looking for when differentiating the different types of regular wide complex tachycardias
A 79-year-old male is brought into the ED by EMS with palpitations and lightheadedness while doing light yardwork. He is found to have a wide complex tachycardia at 155 bpm,…
Wide Complex Tachycardias: What is the Lewis lead and how you can use modified ECG leads to help make the diagnosis
A 60-year-old male presents to the ED with acute chest pain and lower extremity edema. He is noted to be tachycardic on arrival. The following ECG is obtained:
Literature Review: pearls and pitfalls in the ECG diagnosis for ventricular tachycardia
A 45-year-old with no known past medical history presents to the ED with palpitations. She is hemodynamically stable. The following ECG is obtained:
STAT ECG Diagnoses: the great immitator strikes again in a case of wide complex tachycardia
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…
Wide Complex Tachycardias: when administering the wrong medication can cause a “clean kill”
A young patient is brought to the ED complaining of palpitations and mild shortness of breath. The patient does not appear acutely unstable. The following ECG is obtained:
STAT ECG Diagnoses: REALLY wide complex tachycardia
A patient is brought into the emergency department with palpitations, weakness, and shortness of breath. She has a normal blood pressure. The following ECG is obtained:
Wide Complex Tachycardias: when suspected ventricular tachycardia is too wide and too slow
A 56-year-old man with PMHx of HTN, DM, PVD, and ESRD on dialysis presents to the ED with dyspnea. The following ECG was obtained on arrival:
Intermittent runs of nonsustained ventricular tachycardia
A 48-year-old man presents to the ED with 3-4 days of palpitations. The patient has a stable blood pressure but is found to have new onset atrial fibrillation with RVR….
Wide Complex Tachycardias: the three major types of ventricular tachycardia
A 60-year-old man presents to the ED chest pain concerning for ACS, and a prehospital ECG concerning for inferior STEMI. The following ECG is obtained on arrival to the ED:
Wide Complex Tachycardias: ventricular tachycardia (VT) mimics
HPI: A 71-year- old woman with PMHx of HTN and “irregular heart rhythm” presents to the ED with weakness, lightheadedness, and occasional palpitations. She does not know the name of her medications…
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