Casos

Fast Sustained Wide Regular Complex Tachycardia

Dr. Raimundo Barbosa Barros
Dr. Raimundo Barbosa Barros
Brazil

Case presentation

A 58-year-old female patient was admitted to the emergency room with a very fast regular tachyarrhythmia, causing hemodynamic instability: profuse cold sweat, pallor, poor peripheral perfusion, hypotension (BP 80/40 mmHg), tachypneic, low consciousness level. A multinodular of hard consistency goiter is visualized and palpated in the anterior face of the neck. Absence of exophthalmos.
Her daughter refers that she was in regular use of propylthyracil 600mg daily since approximately six months ago.

ECG performed at admission (ECG-1), reverted with electrical cardioversion (100 Joules). ECG-2 performed immediately after cardioversion.

Questions:

  1. Which is the ECG-1 diagnosis?
  2. Which is the ECG-2 diagnosis?
  3. What is the value of having both tracings?

Apresentaçao do caso

Paciente feminina, 58 anos, admitida na sala de emergência com taquiarritmia sustentada regular muito rápida, causando instabilidade hemodinâmica: suor frio e profuso, palidez, má perfusão periférica, hipotensão (PA 80/40 mmHg), taquipneia, e baixo nível de consciência. Volume aumentado na região anterior do pescoço e a palpação de consistência dura e multinodular. Ausência de exoftalmia. A filha refere que está em o uso regular de propilracil 600mg/dia há 6 meses.

ECG realizado na admissão (ECG-1), revertido com cardioversão eléctrica (100 Joules). ECG-2 realizado após a cardioversão.

Perguntas:

  1. Qual o diagnóstico do ECG-1?
  2. Qual o diagnóstico do ECG-2?
  3. Qual o valor de contar com ambos os traçados?

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Auspicios Institucionales
  • Sociedad Argentina de Cardiología
  • Federación Argentina de Cardiología
  • SIAC
  • SADEC
  • Asociación Argentina de Cardiología
  • Latin American Heart Rhythm Society
  • Fundación Barceló - Facultad de Medicina