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Two patients with RBBB

Dr. Smith's ECG Blog

Details of my approach to ECG diagnosis of BBB are beyond the scope of this blog post — but are discussed in the ECG Video below ( or in free download of Section 5 PDF on BBB — from my ECG-2014-ePub ). The rhythm is sinus tachycardia at ~105/minute. The rhythm is sinus tachycardia at ~115/minute.

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A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

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.