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
michelle
68 Year Old Male: Chest Tightness – Part 1
i see some depression and slight elevation in the st segment in the avr. i would alert the stemi crew to stand by.
2015-07-27 17:15:03
sean morrison
68 Year Old Male: Chest Tightness – Part 1
It's the big one Weezy! LAD
2015-07-27 12:48:03
Brooks Walsh MD
Computer misses it, but the medic catches it.
Well this blog is a great place to start! We cover most every aspect of emergency electrocardiography, with a variety of authors, and multiple perspectives, usually in a clinical context. If it is a book you are looking for, I prefer Ken Grauer's. I started with Dr Grauer as a paramedic student and I still…
2015-07-27 01:45:18
michelle
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looks like stemi . o2 , fluids, monitor and transport to nearest facility.
2015-07-26 16:24:04
The Six-Step Method for 12-Lead ECG Interpretation | EMS 12 Lead
Axis Determination – Part I
[…] 2.) Axis determination […]
2015-07-26 13:08:05

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