Wednesday, 9 May 2012

ECG of the Week - 7th May 2012 - Interpretation

This weeks ECG is from a 87 year old female.






Click to enlarge
Rate:
  • ~230
Rhythm:
  • Regular
  • ? p waves visible III ? retrograde

Axis:
  • Normal (+60 deg)
Intervals:
  • PR - Nil clear p waves
  • QRS - Prolonged (160ms)

Interpretation:
  • Broad Complex Tachycardia
Differentials:
  • Ventricular Tachycardia
  • SVT with aberrant conduction - pre-existing or rate related bundle branch block
  • SVT with pre-excitation (WPW)

  • For more on differentiating VT and SVT see the links below.
  • Remember if in doubt treat as VT.

References / Further Reading

Life in the Fast Lane
  • VT vs SVT here
  • Ventricular Tachycardia here
Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.