37 year old female with panic attack

[DartmouthDave]

Ok since my 12 lead is a grey box let's just say that the rhythm is a wide tachycardia at a rate of 270. Bp still 80/40 resp 12. Not obtunded just lethargic.

More in an hour

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Hello,

So, the EKG shows a wide complex tachycardia (WCT).

Is it VT or Sinus Tachycardiac with a aberrant conduction.

I would lean towards VT because:

Young and resonable healthy lifestyle (if I recall the 1st post correctly)

No cardiac histroy

Negative stress test

Slim chance that she has a preexisting BBB

So, I think I would:

1. O2

2. Keep the fluid running

3. Defib x 1 (because she is unstable)

Now, as a remote DD:

1. Hyperthyroidism (causes anxiety, tachycardiac, mood swings, anxiety)

I have seen two female patients with PSVT refractory to cardioverson and medications due to hyperthyroidism.

Sorry, need to run, at work.

Cheers

Sorry for the brief post.....

[ERDoc]

Out of curiosity, what did her cardiac workup involve? Did she have a Holter and if so did she have one of her panic attacks while she was wearing it?

[Just Plain Ruff]

The cardiac work up consisted of a holter monitor and since she didn't have any panic attacks during the time of the holter monitor being on, the holter monitor was negative.

The tachycardia looks a lot like V-tach

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[Chief1C]

Do we have a MAST on board? Just sayin'.

[HellsBells]

Does anyone have MAST anymore? Anyone...

So, lets try sync'd cardioversion at 100J folliwed by 200J, 300J, 360J PRN.