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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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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. Initial ECG in the ED: Presenting ECG : Wide-complex tachycardia at a rate about 200. This is overwhelmingly likely to be ventricular tachycardia, even if only age and medical history are considered. A surprise clue!