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Wide Complex Tachycardia

EMS 12-Lead

David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. 2. Baseline fibrotic substrate from dilated cardiomyopathy leading to VT. The patient was very uncomfortable, dyspneic, and displayed an SpO2 90% on RA.

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InterAtrial Block

EMS 12-Lead

David Didlake, EMT-P, RN, ACNP @DidlakeDW An early 80’s Female was transported to the ED with new-onset facial droop, slurred speech, and focal deficit. No previous medical history was reported. My colleauges and I (interventional cardiology) were asked to consult during workup. Here is the admission ECG.

AFIB 59
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Wide-complex tachycardia that didn’t follow the rules

Dr. Smith's ECG Blog

They had a history of non-ischemic cardiomyopathy (EF 30%), as well as PCI with one stent. Although the emergency physician (along with an APRN and an RN) had not seen any alterations in the rhythm after adenosine was pushed, a paper recording of the episode was subsequently unearthed. A surprise clue!