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David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. Ultimately the patient went to Cath and was found to have multi-vessel obstructive coronary disease with an acute LCX culprit vessel, which was stented.
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!
This was stented. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. Serum Magnesium and Potassium in Acute Myocardial Infarction Influence on Ventricular Arrhythmias Henryk Kafka, MD; Lorrie Langevin, RN; Paul W. After pacing, there was no recurrence of Torsades. The patient stabilized.
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