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Challenges in Clinical Electrocardiography
June 10, 2013

Wide-Complex Tachycardia in a Patient With Coronary Disease—Quiz Case

Author Affiliations
 

SECTION EDITORS: JEFFREY TABAS, MD; PAUL D. VAROSY, MD; GREGORY M. MARCUS, MD; NORA GOLDSCHLAGER, MD

JAMA Intern Med. 2013;173(11):950. doi:10.1001/jamainternmed.2013.109a

A 55-year-old man with a history of hypercholesterolemia and symptomatic premature ventricular complexes treated with a β-blocker was admitted to an outside hospital with acute-onset left-sided chest pressure, palpitations, and lightheadedness. Paramedics at the scene obtained a 12-lead electrocardiogram (ECG) revealing a wide-complex tachycardia at 248 beats per minute (Figure 1), which self-terminated as the patient was being prepared for direct-current cardioversion. The patient was then treated with chewable aspirin and intravenous lidocaine.

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