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JAMA Cardiology Clinical Challenge
August 2017

Wide Complex Tachycardia in an Elderly Woman

Author Affiliations
  • 1Cardiac Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Cardiol. 2017;2(8):923-924. doi:10.1001/jamacardio.2017.1912

A woman in her 70s with history of hypertension presented to the emergency department experiencing chest pain and dyspnea. Her heart rate was 135 beats/min, and her blood pressure was 160/100 mm Hg. A 12-lead electrocardiogram documented wide complex tachycardia (WCT, Figure 1). Bedside transthoracic echocardiogram was notable for left ventricular ejection fraction 45% and moderate mitral regurgitation.

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