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JAMA Cardiology Clinical Challenge
December 26, 2019

Wide Complex Tachycardia in a Woman in Her 30s With Electrolyte Derangements

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Division of Cardiology, Department of Medicine, University of California, San Francisco
JAMA Cardiol. Published online December 26, 2019. doi:10.1001/jamacardio.2019.4838

A woman in her 30s with active bulimia was brought by ambulance to the emergency department after a syncopal event that followed 1 hour of palpitations and intermittent lightheadedness. When emergency responders arrived, the patient was responsive but groggy. An electrocardiogram (ECG) in the field demonstrated a regular wide complex tachycardia. En route to the hospital, 6 mg of adenosine followed by 12 mg of adenosine were administered intravenously, without a change in her rhythm.