A Clinical Scenario to Recognize- Irregular WCT

===================================MY Comment by KEN GRAUER, MD (3/12/2020):===================================A young adult presented to the ED with the “heart awareness” and the ECG shown in Figure-1 — but with no more than slight shortness of breath. BP ~ 130/70.QUESTIONS:What is the cardiac rhythm?How certain are you of your diagnosis?Is the clinical scenario consistent with what you might expect for this rhythm?Figure-1: The initial ECG in the ED (See text).ANSWERS: This young adult appears to be hemodynamically stable  — since his BP is normal and his symptoms are minimal. Knowing this gives us time to focus on the cardiac rhythm. As emphasized in previous posts — I favor a Systematic Approach for the interpretation of any cardiac rhythm, based on assessment of 5 Parameters. These 5 parameters are easily remembered by the saying, “Watch your Ps, Qs& the 3 Rs ” (See My Comment in the October 16, 2019 post).The rhythm in Figure-1 is fast, and irregularly irregular. Although there are some undulations (small deflections) in the baseline (particularly in leads III and V1) — there is no clear sign of P waves. The QRS complex is obviously wide. Putting these ECG findings together — you have described an irregularly irregular WCT ( = Wide-Complex Tachycardia) without clear sign of P waves in a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs