This patient is a 74 year old man who presented to his PCP with five day history of dyspnea on exertion.
+ EKG Interpretation
Dr. Ohlbaum's Explanation
It is obviously wide and fast and regular, what is the differential? Something wide/fast/reg could be some type of fast supraventricular rhythm (SVT or aflutter with 2:1 for example) with aberrant conduction or VT.
How do we know this one is VT?
First of all the morphology with "concordance" of the QRS in all V leads (ie they are all up) is very suggestive of VT.
Secondly, look carefully at Vl and you can see that P waves march thru independent of the QRS - that is AV dissociation which is diagnostic of VT.
(Recreated courtesy of Lifeinthefastlane.com)