Nithin Ramesh Iyer, Adrianus W G J Oomen, Raymond W Sy
{"title":"A challenging broad-complex tachycardia.","authors":"Nithin Ramesh Iyer, Adrianus W G J Oomen, Raymond W Sy","doi":"10.1136/heartasia-2018-011054","DOIUrl":null,"url":null,"abstract":"<p><p>A 53-year-old man presented with chest pain, palpitations and presyncope, without history of overt cardiac disease. The patient was alert. His heart rate was 206 beats per minute, and his blood pressure was 100/50 mm Hg. An intravenous bolus of amiodarone 150 mg was administered in the emergency department. His ECGs preamiodarone and postamiodarone are shown in figure 1. Echocardiography showed low-normal left ventricular systolic function.Figure 1(A) ECG of index arrhythmia. (B) ECG following amiodarone.</p><p><strong>Question: </strong>What should the next diagnostic test be?Referral for electrophysiology study.Referral for urgent coronary angiography.12-lead ECG with posterior lead placement.Bedside adenosine challenge.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011054"},"PeriodicalIF":0.0000,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011054","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Asia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/heartasia-2018-011054","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
A 53-year-old man presented with chest pain, palpitations and presyncope, without history of overt cardiac disease. The patient was alert. His heart rate was 206 beats per minute, and his blood pressure was 100/50 mm Hg. An intravenous bolus of amiodarone 150 mg was administered in the emergency department. His ECGs preamiodarone and postamiodarone are shown in figure 1. Echocardiography showed low-normal left ventricular systolic function.Figure 1(A) ECG of index arrhythmia. (B) ECG following amiodarone.
Question: What should the next diagnostic test be?Referral for electrophysiology study.Referral for urgent coronary angiography.12-lead ECG with posterior lead placement.Bedside adenosine challenge.
53岁男性，主诉胸痛、心悸、晕厥前期，无明显心脏病史。病人神志清醒。患者心率为206次/分钟，血压为100/50 mm Hg，在急诊科静脉注射胺碘酮150 mg。图1所示为他的胺碘酮前后心电图。超声心动图显示左心室收缩功能低正常。图1(A)指标性心律失常心电图。(B)服用胺碘酮后的心电图。问:下一个诊断测试应该是什么?转介进行电生理研究。转介紧急冠状动脉造影。12导联心电图后置导联。床边腺苷挑战。
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