Wide Complex Tachycardias

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…

STAT ECG Diagnoses: regular wide complex tachycardia (RWCT) after succinylcholine?

A middle-age man presents to the ED with acute hypoxemic respiratory failure from multilobar pneumonia. He is intubated using etomidate and succinylcholine and noted to have a change in rhythm…

Wide Complex Tachycardias: regular wide complex tachycardia (RWCT) vs. regular REALLY wide complex tachycardia (RRWCT)

A 70-year-old male presents to the ED with generalized weakness and dizziness. He is suspected to be in atrial fibrillation with a heart rate of ~ 150 bpm. He is…

Differential Diagnoses: must know causes of wide QRS complexes

A 15-year-old girl presents to the ED listless and tremulous. She is unable to provide a reliable history. Her heart rate is around 150 bpm and she is mildly tachypneic…

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

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…

STAT ECG Diagnoses: can’t miss type of wide complex irregular tachycardia

A 37-year-old man is brought to the ED with episodes of palpitations. In the ED he has intermittent episodes of wide complex tachycardia. He is hemodynamically stable. The following ECG…

ECG Basics & Fundamentals: electrical cardioversion of an unstable regular wide complex tachycardia

A 50-year-old man is brought to the ED with a regular wide complex tachycardia (RWCT) shown below. He is pain free with a normal blood pressure and mental status. His…

The perfect wide complex tachycardia algorithm…does not exist!

A 55-year-old man presents to the ED with chest tightness and palpitations. He is noted to have dyspnea and diaphoresis with a normal blood pressure. The following ECG is obtained:

ECG Basics & Fundamentals: can torsades cause seizures?

A 55-year-old man presents to the ED after a witnessed seizure and is somnolent on arrival. He wakes up enough to mumble answers to a few questions but then becomes…

Wide Complex Tachycardias: what is the difference between polymorphic ventricular tachycardia and torsades des pointes

A 13-month-old female is transferred to you for intermittent torsades/dysrhythmias from a community ED. She has been slightly lethargic and has a cardiac history of VSD, ASD, and a PDA…

Wide Complex Tachycardias: what to think of when they are REALLY wide!