Sinus tachycardia masquerading as ventricular tachycardia

We describe here a 87-year-old male who came to the emergency room with the chief complaints of dyspnea and chest pain. His electrocardiogram showed a wide QRS tachycardia with a heart rate of 140 beats/min, a left bundle branch block pattern and low voltage in leads I, aVL, V5 and V6. A long strip...

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Bibliographic Details
Published inTokai journal of experimental and clinical medicine Vol. 15; no. 1; p. 1
Main Authors Kanemoto, N, Atsumi, H
Format Journal Article
LanguageEnglish
Published Japan 01.03.1990
Subjects
Aged
Aged, 80 and over
Bundle-Branch Block - diagnosis
Diagnosis, Differential
Electrocardiography
Humans
Male
Tachycardia - diagnosis
Tachycardia, Sinus - diagnosis
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Summary:We describe here a 87-year-old male who came to the emergency room with the chief complaints of dyspnea and chest pain. His electrocardiogram showed a wide QRS tachycardia with a heart rate of 140 beats/min, a left bundle branch block pattern and low voltage in leads I, aVL, V5 and V6. A long strip showed a premature ventricular complex, and the sinus beat just after the extrasystole showed P waves which were positive in leads I, II, III and a VF similar in shape to those in sinus rhythm. Therefore, a diagnosis of sinus tachycardia with tachycardia dependent left bundle branch block was made. The low voltage in the left lateral leads was ascribed to pneumothorax of the left lung. When a wide QRS tachycardia is encountered in an emergency situation, marked sinus tachycardia with coexistent bundle branch block or aberrant ventricular conduction should be taken into consideration.
ISSN:0385-0005