study_ing
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the ideal way is to look at rate, rythm, etc etc... however lets take an exam oriented short cut preview here
1.in a tacycardia, whats the first q u ask?
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| study_ing
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sheezooo??
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| study_ing
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2.ok id try to figure out if its ventricular vs supraventricular.
how do u determine that?
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| saadtazjam
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Narrow base QRS vs Broad bsed QRs
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| saadtazjam
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Venticular Tachcardia:Wide Complexes
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| study_ing
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great...
1. so what r the differentials of a narrow complex tachycardia?
also remember that a SVT with bundle branch block may present as braod complex.
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4. how do u d/dt a SVT with BBB from a Ventricular tachycardia?
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| saadtazjam
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Differential for Narrow Based QRS is Junctional Tachcardia i.e AV Nodal firing,
whereas BBB also cause Wide BAsed QRS but i presume EKG in LBBB shows RSR'pattern in V5 aqnd V6 and RBBB shows RSR'pattern in V1 and V2 and for Exam purposes Wide complexes are always ventricular tachycardia.
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| study_ing
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hmm ok i'll take ur word for that and not discuss BBB wide based tachys ( THANK GOD  )
remember for almost all unstable pts, the answer is cardiovert
hence we will concentrate on the stable patient.
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| study_ing
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- is it 'ectopics' or V tach?
- if >3 together and rate >120--its VT
- look at morphology...is it the same i.e unifocal, varied or seems to vary like a streamer?
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| study_ing
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if unifocal bigeminy ( ie PVC alternates with narrow complex) --check electrolytes, and do nothing
if 'streamer' i.e varying appearance..TORSADES..
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| study_ing
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ok that was a very short summary ineed..but this is meant to be a short cut overview only for reading ECGs.
- ECG with tachycardia--> look for clues in the case regarding INSTABILITY. if unstable, cardiovert
- is the tachy broad vs narrow complex?
- if broadcomplex--> ventricular more likely
- Ventricual beats>3 at rate>120= VT
- is it unifocal, has changing axes ( torsades) or highly variable ( V fib?)
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| study_ing
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shud we move on to the narrow complex?
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| X-Ray
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Here is a good one
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| sheeezooo
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so small
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| study_ing
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thanx x-ray..actually supplementing it with images sounds great..thanx 
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| study_ing
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okie narrow complex...think abt the d/f ..and proceed to read to figure which one is this..
SVT
1. what's teh first q u ask?
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| study_ing
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1.IS it reular or irregular.
2. second q--what about the P wave
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| X-Ray
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well there is a
limit of what you can post
oh well
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| study_ing
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- irregular, P waves none or weird-->atrial fibrillation
- 3 or more morphology-->MAT ( multifocal atrial tachycardia)
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