Adenosine for sinus tachycardia: Try to avoid this!

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This is the feedback I gave the student on this case. (Recall that this was a young adult male who presented with dyspnea, chest pain, as well as pre-syncope, whose initial ECG showed a brisk tachycardia which went up to the 170s at points): Bottom line: “As you point out, this was sinus tachycardia. When […]

The first iPad mini goes to . . . #EMSToday2015

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Well, apparently at least one of you registered for EMS Today 2015 using promo code EMS12LEAD during checkout. How do I know this? Because I was recently notified by our friends at PennWell that the first drawing for an iPad Mini is complete! The winner is . . . Steven Caho! Congratulations, Steven! If you’re reading this […]

Adenosine given for a narrow-complex tachycardia over 150

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This case comes to me from a paramedic trainee. Many elements have been altered to preserve anonymity. In the following, the narrative from the run-form is interspersed with questions that I put to the student afterwards. I was trying to draw out how a student understood the evaluation and management of tachyarrhythmias. But I don’t […]

The 12 Leads of Chistmas: V2

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This article is the tenth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V2 I love V2. It’s probably been my favorite lead to examine and ponder this past year. The cool thing is that it doesn’t seem all […]

The 12 Leads of Christmas: V5

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This article is the ninth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V5 We’re getting into the home-stretch in our little series. I wasn’t entirely sure if we were going to make it through since a few of […]

The 12 Leads of Christmas: V4

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This article is the eighth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V4 Like aVF, V4 is a tough lead to discuss on its own. It’s part of the natural flow of the complexes across the precordium and […]

The 12 Leads of Christmas: V1

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This article is the seventh in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V1 Happy New Year everyone! Today’s post is going to be a bit of a hodge-podge as I recover from yesterday’s post on ST-elevation in aVR. […]

The 12 Leads of Christmas: aVR

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This article is the fifth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead aVR I have a love-hate relationship with aVR. There is one big question that always looms around it: Is ST-elevation in aVR a STEMI-equivalent? Like most […]

The 12 Leads of Christmas: aVF

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This article is the fifth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead aVF I dug myself quite a hole on this one as there’s really not much to say about aVF. It’s located midway between leads II and […]

The 12 Leads of Christmas: aVL

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This article is the fourth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead aVL Today’s  review is going to be light on text (but heavy on EKG’s) to make time for Wednesday’s big post on aVR. It also helps that […]

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Comments
Anne
Adenosine for sinus tachycardia: Try to avoid this!
If it were me, I would seek a second opinion; consult an electrophysiologist. Unlikely that you had sinus tachycardia at that rate.
2015-01-26 09:46:57
John
Adenosine given for a narrow-complex tachycardia over 150
If things such as Sepsis, Drug Use, Medication issues, Anxiety, Pain, etc.. have been ruled out, and the rate is still >160 (or whatever number you use). How else do you determine S-Tach Vs. SVT? Does a 12 Lead Help (QRS Complexes facing different directions due to different pathways etc..) or a simple 4 Lead?…
2015-01-19 19:44:32
Brandon O
Adenosine for sinus tachycardia: Try to avoid this!
She may not have had anxiety, but I bet she was a carrier...
2015-01-18 02:31:08
Brooks Walsh MD
Adenosine for sinus tachycardia: Try to avoid this!
Highly unusual for this to be sinus at that rate!
2015-01-17 19:21:04
Mel
Adenosine for sinus tachycardia: Try to avoid this!
I experience bouts of tachycardia. I had it investigated about 5 years ago after being woken during the night by projectile vomiting and feeling my heart racing/thumping with carotid pulse that I could certainly palpate but had no chance of counting (whether the 2 symptoms were related or coincidental, I don't know). I've had multiple…
2015-01-17 18:47:19

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