Remove Atrial Flutter Remove Echocardiogram Remove Tachycardia
article thumbnail

Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. There are no P waves preceding the QRS complexes, and no clear flutter waves.

article thumbnail

Young Man with a Heart Rate of 257. What is it and how to manage?

Dr. Smith's ECG Blog

Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. See Learning point 1 below. Learning points 1.

article thumbnail

New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?

Dr. Smith's ECG Blog

Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. There is a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. See my quick review of atrial tachycardia below) The tachycardia spontaneously resolved.

article thumbnail

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

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. Most physicians will automatically be worried about these symptoms. The tracings were considered abnormal in the following cases: 1.

article thumbnail

Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). This patient very likely has some form of idiopathic ventricular tachycardia. Of the ventricular outflow tract tachycardias (RVOT-VT) makes up 80-90%.