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A patient presenting at the emergency department with symptoms of palpitations

Acute ECG Challenge - Episode 2

12/08/2020 20:00 12/08/2020 Europe/Paris A patient presenting at the emergency department with symptoms of palpitations contact@escardio.org DD/MM/YYYY
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Summary

An accurate interpretation of a 12 lead ECG recorded within 10 minutes after admission is essential in managing patients presenting at the emergency department with symptoms of palpitations caused by a paroxysmal tachycardia. When the ECG shows a regular broad QRS tachycardia, it is crucial to differentiate a ventricular tachycardia from supraventricular tachycardia with a pre-existent conduction disorder or aberrant conduction or an antidromic AV reentry tachycardia using an accessory atrioventricular pathway.  In this ECG challenge, we discuss a patient presenting with broad QRS tachycardia and the ECG criteria for the diagnosis of ventricular tachycardia.



The Challengee: Dr. Pablo Jorge Perez, Spain

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"This live experience pushed me out of my comfort zone and I felt it like a real-case! To be able to discuss the management and impressions gives a good opportunity to reflect on your decisions. Thanks for inviting me, I want more!!

Regarding the case, face a wide QRS tachycardia is always a challenge. First, the discussion about pharmacological vs electrical cardioversion is always interesting. I think adenosine is helpful in non-unstable patients. 12-ECG suggested VT after algorithm were applied, but often is challenging and requires a teamwork approach."


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