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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. RVEF 100 ml/m2.
This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? Because the patient was exercising, which increases sympathetic tone, facilitating AV conduction. Troponins 34>33>43, likely secondary to myocardial injury from tachycardia. What do you want to do? Why such rapid AV conduction?
Typically — these arrhythmias are induced by exercise or intense emotional states ( ie, associated with increased catecholamine discharge ). As a result — ETT ( Exercise Treadmill Testing ) can be used to elicit BDVT, and therefore help to diagnosie CPVT. As a result — the resting ECG tends to be normal.
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