RVOT https://www.ecgguru.com/taxonomy/term/726/all en Ventricular Tachycardia In A Patient With Myopathy https://www.ecgguru.com/ecg/ventricular-tachycardia-patient-myopathy <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ventricular-tachycardia-patient-myopathy"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/VT.png" width="1800" height="734" alt="" /></a></div><div class="field-item odd"><a href="/ecg/ventricular-tachycardia-patient-myopathy"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/RVOT.jpg" width="1800" height="605" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal">These two ECGs are from a 77-year-old woman who was complaining of palpitations and mild shortness of breath.  She stated a history of atrial fibrillation.  She was alert, with a systolic BP over 120.  At the hospital, she was found to have cardiomyopathy, resulting in global hypokinesis. She also had significant coronary artery narrowing in her left main, left anterior descending, and circumflex, which were treated with coronary artery bypass graft surgery.</p><p class="MsoNormal"><strong><span style="font-size: 12.0pt; line-height: 107%;">The first ECG </span></strong>was taken on arrival of the EMS crew at the patient’s home.  It shows ventricular tachycardia, rate 226 bpm, <strong>All WCTs should be considered to be ventricular tachycardia until proven otherwise.  </strong><span style="font-size: 13.008px;">While WCT can sometimes be difficult to definitively diagnose in the field, this ECG has many features which favor the diagnosis of VT, including:</span></p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l1 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">         </span></span><!--[endif]-->An extremely wide QRS (I measure .24 sec., the machine measures .368 sec.).</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">         </span></span><!--[endif]-->An extreme left axis deviation (aVF is all negative).</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">         </span></span><!--[endif]-->Absence of either RBBB or LBBB pattern, with a  completely negative QRS in V6.  This all negative V6 places the liklihood of the rhythm being VT to about 100%.</p></div></div></div> Wed, 20 Dec 2017 05:15:44 +0000 Dawn 748 at https://www.ecgguru.com