Great Regular WCT with P Waves — ME NOT GIVING AWAY ANSWER

Here is the case:

Blaine's case on EKG Club

Here is the tracing:

The ECG — This is obvious VT!

Here is MY ANSWER

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I have rotated this tracing. Rather than “spilling the beans” with full interpretation — I will simply describe the 2 things that every provider needs to consider in their evaluation BEFORE arriving at a presumptive diagnosis.

#1) Is this patient in front of me hemodynamically stable or not? The answer is not necessarily a “Yes” or a “No” — but may be in a gray zone in between (which translates to a need to within short order arrive at a better resolution of the clinical situation). WHAT is suggested here?

#2) The 5 parameters to always assess in rhythm interpretation are recalled by “Watch your Ps, Qs & the 3 Rs”. Isn’t the rhythm here a regular WCT ( = Wide-Complex Tachycardia) at ~150/minute without clear sign of sinus P waves? Even BEFORE considering QRS morphology — WHAT is the differential diagnosis for such a rhythm?

For those wanting to review the Basics of Rhythm Interpretation — Please check out the Contents to my 3-part ECG Video series on this subject — http://ecg-interpretation.blogspot.com/p/c-lick-h-ere-to-get-back-to-my-ecg-blog_7.html — :)

For those wanting to be walked through the process of what to consider for the regular WCT rhythm — Please GO TO — http://ecg-interpretation.blogspot.com/2012/05/ecg-interpretation-review-42-vt-brugada.html — :)

Please TAG ME when there have been additional responses to this case! I will then gladly respond in more detail!

NOTE: Blaine Holman posted this on 11/11/2015 — but then TOOK DOWN this post after I wrote the above ... so I messaged her. I LIKE MY ANSWER — as my goal is to get others to think.