EKG of the Week

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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.

Brugada Criteria

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(Recreated courtesy of Lifeinthefastlane.com)

Further Reading:

Follow up EKGs:

Full EKG Index