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She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for a regular tachycardia, possible rales at both bases, some mild RUQ abdominal tenderness. Thus, I believe it is a regular, monomorphic, wide complex tachycardia. Or it could simply still be classic VT. What is the Diagnosis?
Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate. Essential Reading : Full text link: AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part IV: The ST Segment, T and U Waves, and the QT Interval (full text link).
If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Abnormal ECG – looks for cardiac syncope.
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