A 12 year old with Wide Complex Tachycardia

A previously healthy 12 year old presented to the ED with a “fast heart rate” that had started about 1.5 hours prior to presentation.  She was reportedly a healthy child and active in several sports. She had a fairly active day and had been swimming off of a boat when her sy…
To learn more visit: Dr. Smith’s ECG Blog

NOTE: To facilitate viewing — I have made up a Timed CONTENTS with LINKS (!) — which allows you to instantly Fast Forward on YouTube if you want to focus on a specific area (GO TO — http://ecg-interpretation.blogspot.com/p/n-ote-easy-link-my-17-minute-ecg-video.html). This 25-minute ECG Video (my 7th) — reviews the case of a 70-year old woman with chest pain who presents in a WCT (Wide-Complex Tachycardia) of uncertain etiology. Is this VT? And, if you think it is — How certain are you of your diagnosis? Our interpretation is discussed in detail. NOTE: Links to my ECG Videos (including a folder with Power Point Shows of these videos) — as well as info on my other ECG Resources can be found at — http://www.videoecg.com — Your Questions and Feedback are welcome!
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TIMED CONTENTS (Click on Links to Fast Forward! ):
0:00 – Introduction (How to contact me).
0:53 – Case Presentation (12-lead ECG & rhythm strip).
2:02 – Look at the Patient First (Stable? What to do First?).
2:44 – You May Need to Treat BEFORE Knowing the Rhythm.
3:45 – Initial Rhythm Analysis should be done in less than 3 Seconds.
4:42 – IF Unstable because of a Fast Rhythm – Cardiovert!
5:10 – Step-by-Step Rhythm Analysis of this ECG (Ps,Qs,3Rs).
6:54 – The Rhythm is Not Regular … ( “Other Stuff” going on).
7:20 – Start with what you Know (Look for the Underlying Rhythm).
7:54 – Using the Ps, Qs, 3R Approach for the Underlying Rhythm.
9:35 – The Long Lead II Rhythm Strip (What are the narrow beats?).
10:28 – Looking at the 2 Runs of a Regular WCT Rhythm (Is this VT?).
11:05 – Identifying AV Dissociation (Fusion & Capture beats).
13:49 – Advanced Concepts: Concealed Conduction (prolonged PR).
15:58 – Using the 12-Lead with a Regular WCT (axis; QRS morphology).
17:45 – Using QRS Morphology with a Regular WCT (leads I,V1,V6).
19:30 – Use of the Post-Conversion Tracing (confirming VT; ST-T changes).
Video Rating: / 5

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A 12 year old with Wide Complex Tachycardia

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