Episode 907: Wide-Complex Tachycardia
Emergency Medical Minute12 Juni 2024

Episode 907: Wide-Complex Tachycardia

Contributor: Travis Barlock MD

Educational Pearls:

  • Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds

  • Wide-complex tachycardia of supraventricular origin is known as SVT with aberrancy

    • Aberrancy is due to bundle branch blocks

    • Mostly benign

    • Treated with adenosine or diltiazem

  • Wide-complex tachycardia of ventricular origin is also known as VTach

    • Originates from ventricular myocytes, which are poor inherent pacemakers

    • Dangerous rhythm that can lead to death

    • Treated with amiodarone or lidocaine

  • 80% of wide-complex tachycardias are VTach

    • 90% likelihood for patients with a history of coronary artery disease

  • In assessing a wide-complex tachycardia, it is best to treat it as a presumed ventricular tachycardia

    • Treating SVT with amiodarone or lidocaine does no harm

    • However, treating VTach with adenosine or diltiazem may worsen the condition

References

1. Littmann L, Olson EG, Gibbs MA. Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach. Am J Emerg Med. 2019;37(7):1340-1345. doi:https://doi.org/10.1016/j.ajem.2019.04.027

2. Viskin S, Chorin E, Viskin D, Hochstadt A, Schwartz AL, Rosso R. Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy. Circulation. 2021;144(10):823-839. doi:10.1161/CIRCULATIONAHA.121.055783

3. Williams SE, O'Neill M, Kotadia ID. Supraventricular tachycardia: An overview of diagnosis and management. Clin Med J R Coll Physicians London. 2020;20(1):43-47. doi:10.7861/clinmed.cme.20.1.3

Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit

Avsnitt(1147)

Podcast 864: Arterial Blood Gas (ABG) vs Venous Blood Gas (VBG)

Podcast 864: Arterial Blood Gas (ABG) vs Venous Blood Gas (VBG)

Contributor: Aaron Lessen MD Educational Pearls: What is measured in an ABG/VBG? Blood values for oxygen tension (pO2), carbon dioxide tension (pCO2), acidity (pH), oxyhemoglobin saturation, and bic...

14 Aug 20232min

Podcast 863: Treatments for Alcohol Use Disorder

Podcast 863: Treatments for Alcohol Use Disorder

Contributor: Aaron Lessen MD Educational Pearls: Patients with alcohol use disorder are frequently discharged from the ED without further resources Pharmacological treatments to reduce cravings in...

7 Aug 20232min

Podcast 862: How to Apply a Painful Stimulus

Podcast 862: How to Apply a Painful Stimulus

Contributor: Travis Barlock MD Educational Pearls: When might you need to apply a painful stimulus in a medical setting? The main reason is to assess the patient's level of consciousness, such as wh...

31 Juli 20232min

Podcast 861: Alcohol Withdrawal and Delirium Tremens

Podcast 861: Alcohol Withdrawal and Delirium Tremens

Contributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the "depressive" effects of ethanol beverages. Over time, alcohol d...

24 Juli 20234min

Ukraine Brewtalk Featuring Dr. Dave Young

Ukraine Brewtalk Featuring Dr. Dave Young

Contributors: David Young MD, John Hesling MD, Travis Barlock MD, Jeffrey Olson Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss several clips from the even...

21 Juli 202338min

Podcast 860: Thyrotoxicosis

Podcast 860: Thyrotoxicosis

Contributor: Travis Barlock MD Educational Pearls: Clinical picture: A patient comes in with altered mental status, tachycardia, fever, elevated T4, and low TSH. What's the diagnosis?... Thyrotoxicosi...

20 Juli 20232min

Podcast 859: Teamwork Really Makes the Dream Work

Podcast 859: Teamwork Really Makes the Dream Work

Contributor: Aaron Lessen MD Educational Pearls: 33 Medical residents and 91 nurses at Massachusetts General Hospital were randomized into two groups: Intervention group: 15 PGY-1 residents assig...

10 Juli 20232min

Podcast 858: Whole Blood Pregnancy Test

Podcast 858: Whole Blood Pregnancy Test

Contributor: Meghan Hurley MD Educational Pearls: What do you do if you need a stat pregnancy test on an incapacitated patient? You can send a serum quantitative human chorionic gonadotropin (beta-H...

3 Juli 20234min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-ufo-bortom-rimligt-tvivel
sexet
rss-vetenskapsradion-2
paranormalt-med-caroline-giertz
rss-experimentet
hacka-livet
medicinvetarna
det-morka-psyket
dumforklarat
4health-med-anna-sparre
halsorevolutionen
rss-spraket
bildningspodden
pojkmottagningen
rss-personlighetspodden