{"id":388,"date":"2015-12-05T15:17:33","date_gmt":"2015-12-05T15:17:33","guid":{"rendered":"http:\/\/torreyekg.com\/?p=388"},"modified":"2015-12-05T15:19:14","modified_gmt":"2015-12-05T15:19:14","slug":"ekg-of-the-week-12","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2015\/12\/05\/ekg-of-the-week-12\/","title":{"rendered":"EKG of the Week #12"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/12.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-389 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/12.png\" alt=\"12\" width=\"647\" height=\"397\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/12.png 647w, http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/12-300x184.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\n50-year-old man with palpitations and chest tightness.<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Interpretation &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\nThis rhythm is a regular wide-complex tachycardia. By definition, this rhythm is <strong>ventricular tachycardia<\/strong> until proven otherwise. Fully 70% of WCT is v. tach. Other causes of WCT include SVT with 1) rate-related changes (aberrancy), 2) pre-existing bundle branch block, or 3) antidromic conduction down a bypass tract (WPW).\n<p>Some electrocardiographic clues that suggest ventricular tach include QRS concordance (QRS complexes in chest leads all predominantly negative or positive), very wide QRS complexes (eg QRS &gt; 160 msec with LBBB), extreme right axis (-90\u00b0 to \u00b1180\u00b0), and evidence of AV dissociation.<\/p>\n<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/Screen-Shot-2015-12-05-at-10.15.47-AM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-390 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/Screen-Shot-2015-12-05-at-10.15.47-AM.png\" alt=\"Screen Shot 2015-12-05 at 10.15.47 AM\" width=\"346\" height=\"149\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/Screen-Shot-2015-12-05-at-10.15.47-AM.png 346w, http:\/\/torreyekg.com\/wp-content\/uploads\/2015\/12\/Screen-Shot-2015-12-05-at-10.15.47-AM-300x129.png 300w\" sizes=\"auto, (max-width: 346px) 100vw, 346px\" \/><\/a><\/p>\n<p>While there are many criteria for predicting v. tach, clinical association is as good as any electrocardiographic criteria. If the patient has a cardiac history, it is v. tach 97% of the time! (Lift up the hospital gown and look for the sternotomy scar!)<\/p>\n<p>And in an emergency, treat wide-complex tachycardia (WCT) per current ACLS protocols.<br \/>\n<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>50-year-old man with palpitations and chest tightness.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-388","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=388"}],"version-history":[{"count":2,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/388\/revisions"}],"predecessor-version":[{"id":392,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/388\/revisions\/392"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=388"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=388"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}