Weekly ECG Challenge – Week 2

This week, we are presenting three challenging cases involving Wide Complex Tachycardias (WCT). Your task is to analyze the ECGs provided and match each case scenario to the correct ECG.

While reviewing each case, consider the possible underlying causes of the wide complex tachycardia and appropriate treatment options for each scenario.

Case A

A 24-year-old female contacted EMS, reporting an overdose 20 minutes ago. Upon your arrival 10 minutes later, she is delirious and tachycardic, with a blood pressure of 80/50 mmHg. Notably, her mucous membranes are dry.

Case B

A 70-year-old male with a history of coronary artery disease (CAD) and coronary stents is experiencing chest pain and was pre-syncopal before your arrival. He is currently alert but tachycardic, with a blood pressure of 100/70 mmHg.

Case C

A 64-year-old male with a history of diabetes mellitus (DM) and previous diabetic ketoacidosis (DKA) presents with nausea and vomiting throughout the day. He appears unwell, and is tachycardic, with a stable blood pressure and a respiratory rate of 32 breaths per minute.

Instructions:

Review the three provided ECGs.

Match each case (A, B, or C) to the corresponding ECG.

Consider the most likely diagnosis for each patient and the appropriate pre-hospital management strategies.