Name that ECG: 51 year old male – Findings

This is the conclusion to Name that ECG: 51 year old male.

51 year old male, palpitations.

Name that ECG: 51 year old male

 

Rhythm:

  • Rate: ventricular rate ~185 bpm, unknown atrial rate
  • Regularity: regular
  • P-waves: none appreciated
  • PRi: N/A
  • QRS duration: ~200 ms

Bonus points:

  • Axis: inferior, +90 degrees
  • Bundle Branches: V1-negative, wide-complex
  • QTc: not appreciable
  • ST/T-waves:
    • T-waves: appropriate discordance in all leads
    • ST-elevation: not readily interprettable
    • ST-depression: not readily interprettable

Differentials:

  • Ventricular tachycardia

Notes:

  • Subtle dissociation of the atria may be visible in the ST/T-waves in II and III.
  • It is unlikely that this rhythm is anything but ventricular tachycardia.
  • The ST-segments in aVL are arguably excessive, potentially indicating an ACS cause of this tachycardia.

 

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Comments
Ivan Rios
The role of 12 lead ECG in Pediatric Pulmonary Hypertension
Thanks for writing Tyler. They are the same thing. Strain pattern is just the result of increased pressures against the ventricles which alters the way repolarization occurs from epicardium to endocardium. Similar to stepping on a puddle of water. Your show spreads the water away from the area of pressure. The ST segment is slightly…
2014-12-17 18:44:24
Tyler
The role of 12 lead ECG in Pediatric Pulmonary Hypertension
Can you explain how these ST segment and T wave changes can be differentiated from right strain pattern?
2014-12-17 18:18:25
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