20-year old patient with sudden onset of palpitations. What does the ECG show?
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
Main Abnormalities
Pseudo R’ waves
CLINICAL PEARLS
Differential Diagnosis
When you see a regular narrow complex tachycardia at 150 bpm, you should think of four main diagnoses:
The patient’s young age and presence of retrograde P waves (pseudo R’ waves) suggest a paroxysmal reentry tachycardia involving the AV node — either AVNRT (“SVT”) or orthodromic AVRT.
The next step is a therapeutic trial of vagal maneouvres and/or adenosine… (see Quiz ECG 017).
Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |