Dysrhythmias V

Cardiovascular System


{"ops":[{"insert":"A 68-year-old woman is seen in the office for a routine health maintenance examination. She complains of intermittent chest pain. She has a history of a prior myocardial infarction and moderate hypertension. Her pulse is 76\/min and blood pressure is 150\/100 mmHg. Cardiac examination shows a regular rate and rhythm with no murmurs. An electrocardiogram (ECG) shows a normal-appearing P wave and PR interval, a QRS duration of 150 milliseconds, a notched R wave in leads I, AVL, V5 and V6, and the absence of a Q wave in leads I, V5 and V6.\n\nWhich of the following is the most likely diagnosis?"},{"insert":"\n"}]}

Background

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(A)

Left bundle branch block
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(B)

Right bundle branch block
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(C)

Ventricular tachycardia
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(D)

Accelerated idioventricular rhythm
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(E)

Wolff-Parkinson-White syndrome
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References

{"ops":[{"insert":"SURAWICZ B, CHILDERS R, DEAL BJ, GETTES LS, BAILEY JJ, GORGELS A, HANCOCK EW, JOSEPHSON M, KLIGFIELD P, KORS JA, MACFARLANE P, MASON JW, MIRVIS DM, OKIN P, PAHLM O, RAUTAHARJU PM, VAN HERPEN G, WAGNER GS, WELLENS H, AMERICAN HEART ASSOCIATION ELECTROCARDIOGRAPHY AND ARRHYTHMIAS COMMITTEE, COUNCIL ON CLINICAL CARDIOLOGY., AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION., HEART RHYTHM SOCIETY.. AHA\/ACCF\/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol [online] 2009 Mar 17, 53(11):976-81 [viewed 23 November 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19281930"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"WAGENVOORT LME, WILLEMSEN RTA, KONINGS KTS, STOFFERS HEJH. Interpretations of and management actions following electrocardiograms in symptomatic patients in primary care: a\u00a0retrospective dossier study. Neth Heart J [online] 2019 Oct, 27(10):498-505 [viewed 23 November 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31301001"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"GILDEA TH, LEVIS JT. ECG Diagnosis: Accelerated Idioventricular Rhythm Perm J [online] 2018 Mar 16:17-173 [viewed 24 November 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5882183"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"B GARNER J, M MILLER J. Wide Complex Tachycardia - Ventricular Tachycardia or Not Ventricular Tachycardia, That Remains the Question. Arrhythm Electrophysiol Rev [online] 2013 Apr, 2(1):23-9 [viewed 24 November 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26835036"},{"insert":"\n","attributes":{"list":"ordered"}}]}

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