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Test yourself with this week’s ECG case. Then scroll down for a structured step-by-step interpretation and clinical pearl.
A 70 year old presented with weakness
The final interpretation is ‘wide QRS tachycardia’ – what’s the treatment?
– Heart rate/rhythm: regular wide complex tachycardia with sinus P waves (upright in II, biphasic in V1) = sinus tach
– Electrical conduction: atypical LBBB
– Axis: left
– R-wave progression: late
– Tall/small voltages: normal
– ST/T: discordant and proportional
sinus tachycardia: treat underlying cause.
Tachycardia resolved (and LBBB remained) after treatment for sepsis
ACLS is designed for primary arrhythmias. But regular wide complex tachycardia that is driven by sinus P waves (upright in II, biphasic in V1) = sinus tach = treat secondary causes
