Sudden Thump
Cardiovascular System
{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient has experienced an episode of rapid but regular palpitations, which suggests either sinus tachycardia, supraventricular tachycardia (SVT) or ventricular tachycardia (VT).\n\nThe faintishness and feeling of impending doom suggests hemodynamic compromise. While this favors VT, it should be kept in mind that SVT of a sufficiently high rate may cause cardiac decompensation.\n\nFurther differentiation is best performed by evaluating the ECG obtained during the episode of palpitations.\n\nHis ECG shows a broad complex tachycardia, limiting the possibilities to VT; SVT with a bundle branch block; or SVT via an accessory pathway with antidromic conduction.\n\nECG features of use in differentiating VT from SVT include:\n\n1. AV disassociation (i."}]}
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