You have a patient in the emergency department with a history of high fevers and cough. He is initially, very dehydrated, tachycardia and hypoxic on room air. The nurse calls you and says that the patient is going into ventricular tachycardia(VT). His ECG is as below.
What do you do now? Read more for the answer...
You should do nothing as this is artefact, secondary to the rigours the patient is have due to pneumococcal pneumonia. If you look closely at the ECG, the patient’s underlying rhythm is still running under all the artefact.
Below is a further example of the same thing:
Whilst this looks like VT, the underlying rhythm can be clearly seen. It is also a giveaway that lead I is totally normal.
A further example is from a holter monitor tracing. The results cam back and an example of wide complex rhythm thought to be VT is shown below:
The ECG shows a wide complex tachycardia. However, lead II is almost normal. It is not possible to have most of the heart inVT and a small amount at normal rhythm. This was in fact, the patient playing a video game on their phone. When paying the vibrations where made obvious.
There are various causes of wide complex tachycardia.