60 year old male with chest pain for 60 minutes.
PMH: HTN, CAD s/p MI; VS: 110/80 180 O2sat 96%
Answer & Explanation
Wide-complex tachycardia in a gentleman with a cardiac history including prior MI – think no further about the etiology of this rhythm…this is V tach.
What to do? Remember ACLS protocols (and common sense) – this gentleman is having chest pain. With his history, wouldn’t you like to see what is going on under all that wide-complex tachycardia? Besides, although his vital signs are currently stable, do we ever let people with active chest pain sit about with a heart rate of 180? Seriously, even though he seems very stable, this rhythm needs to be treated aggressively – electricity is the right answer.
Now his acute inferior MI is easily observed, and he is quickly taken to the cath lab!