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
Alex
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>>Too perfectly lined up with the T-waves, while the isoelectric line is relatively stable, to be strictly movement artifact. Can these spasms be sync-d with (or caused by) mechanical movement of the heart walls?
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Erich
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[…] http://www.ems12lead.com/2014/09/11/the-360-degree-heart-part-i/ […]
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[…] you understand axis as well as you’d like? The EMS 12-Lead blog gives us the first in a new series on understanding axis on the ECG. […]
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