Cardiology Letters 2024, 33(3):183-188

A nearly misdiagnosed wide complex tachycardia: all algorithms have flaws

Joana Silva Ferreira, Dinis Mesquita, Marta Fonseca, Leonor Parreira

Department of Cardiology, Centro Hospitalar de Setúbal, Setúbal, Portugal

Wide complex tachycardia is a common presentation in the Emergency Department. Although differentiating between supraventricular and ventricular tachycardia is critical for an appropriate treatment, it can still prove quite challenging. Clinicians usually make this distinction based on clinical context and several electrocardiographic criteria and algorithms. We report a case of wide complex tachycardia where these criteria were conflicting and where the correct diagnosis was only established through the careful analysis of serial electrocardiograms during the treatment of the arrhythmia. It therefore highlights the importance of performing electrocardiograms before and after treatment and of meticulously analysing them, beyond the diagnostic algorithms, before making a final diagnosis.

Keywords: atrial flutter; ECG; supraventricular tachycardia; ventricular tachycardia

Published: March 1, 2024  Show citation