{"id":8083,"date":"2025-07-24T14:11:10","date_gmt":"2025-07-24T11:11:10","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8083"},"modified":"2025-07-24T14:11:10","modified_gmt":"2025-07-24T11:11:10","slug":"ecg-challenge-heart-patient-with-a-racing-pulse","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/ecg-challenge-heart-patient-with-a-racing-pulse\/","title":{"rendered":"ECG Challenge: Heart Patient With a Racing Pulse"},"content":{"rendered":"<div>ECG Challenge: Heart Patient With a Racing Pulse<\/div>\n<div><\/div>\n<div>Published: July 18, 2025<\/div>\n<div>Source: Medscape<\/div>\n<div><\/div>\n<div>Key Scientific Takeaways:<\/div>\n<div><span> 1. Diagnosis: Ventricular Tachycardia (VT)<\/span><\/div>\n<div><span> \u2022 Confirmed by ECG interpretation and AV dissociation; correctly identified by 56% of peers.<\/span><\/div>\n<div><span> 2. ECG Findings:<\/span><\/div>\n<div><span> \u2022 Regular tachycardia at 132 bpm<\/span><\/div>\n<div><span> \u2022 Wide QRS duration (0.16 sec), resembling but atypical for RBBB<\/span><\/div>\n<div><span> 3. Axis Deviation:<\/span><\/div>\n<div><span> \u2022 Extreme left axis deviation (positive in lead I, negative in II\/aVF)<\/span><\/div>\n<div><span> 4. AV Dissociation:<\/span><\/div>\n<div><span> \u2022 Occasional P waves occur independently from QRS complexes \u2192 confirms AV dissociation, a hallmark of VT.<\/span><\/div>\n<div><span> 5. ST-T Wave Abnormalities:<\/span><\/div>\n<div><span> \u2022 Reflects aberrant ventricular activation and possible superimposed P waves.<\/span><\/div>\n<div><span> 6. QT Interval Analysis:<\/span><\/div>\n<div><span> \u2022 QT\/QTc measured at 380\/560 ms, but normalized to 300\/445 ms when adjusted for wide QRS.<\/span><\/div>\n<div><span> 7. Consideration of Fascicular VT:<\/span><\/div>\n<div><span> \u2022 RBBB-like morphology + left axis \u2192 might suggest left posterior fascicular VT<\/span><\/div>\n<div><span> \u2022 Yet, history of CAD and MI makes ischemic VT far more likely<\/span><\/div>\n<div><span> 8. Pathophysiology of VT:<\/span><\/div>\n<div><span> \u2022 VT arises from reentrant circuits within ventricular tissue, bypassing the His\u2013Purkinje system, causing abnormal conduction and ECG changes.<\/span><\/div>\n<div><\/div>\n<div>Conclusion:<\/div>\n<div>A wide-complex tachycardia with AV dissociation and abnormal axis\/QRS features confirms ventricular tachycardia in a patient with coronary artery disease and previous MI.<\/div>\n<div><\/div>\n<div><a href=\"http:\/\/www.medscape.com\/viewarticle\/ecg-challenge-heart-patient\">http:\/\/www.medscape.com\/viewarticle\/ecg-challenge-heart-patient<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>ECG Challenge: Heart Patient With a Racing Pulse Published: July 18, 2025 Source: Medscape Key Scientific Takeaways: 1. Diagnosis: Ventricular Tachycardia (VT) \u2022 Confirmed by ECG interpretation and AV dissociation; correctly identified by 56% of peers. 2. ECG Findings: \u2022 Regular tachycardia at 132 bpm \u2022 Wide QRS duration (0.16 sec), resembling but atypical for [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8083","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8083","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8083"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8083\/revisions"}],"predecessor-version":[{"id":8084,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8083\/revisions\/8084"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8083"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8083"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8083"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}