EKG of the Week

8-28 EKG_Page_1.jpg

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


VENTRICULAR TACHYCARDIA

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.

Brugada Criteria

alt text


(Recreated courtesy of Lifeinthefastlane.com)

Further Reading:

Follow up EKGs:

Full EKG Index