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Masquerade: a malignant arrhythmia masquerading as benign.
R Nandakumar1, J C Patel, P Broadhurst
1Aberdeen Royal Infirmary, Aberdeen, UK. nandakumar.ramasami@arh.grampian.scot.nhs.uk
Heart (British Cardiac Society)
|January 20, 2004
Summary
Malignant ventricular tachycardia can mimic benign atrial flutter on electrocardiograms (ECGs). Careful comparison of QRS complex morphology across all leads is crucial for accurate diagnosis.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Pseudoatrial flutter is typically associated with benign causes.
- Distinguishing between benign and malignant arrhythmias is critical for patient management.
Observation:
- An 82-year-old patient presented with symptoms suggestive of atrial flutter.
- Electrocardiogram (ECG) revealed an electrical artifact that mimicked atrial flutter.
Findings:
- The observed arrhythmia was identified as ventricular tachycardia, a malignant condition.
- Morphological comparison of QRS complexes between the rhythm strip and lead II confirmed ventricular origin.
Implications:
- This case highlights the potential for malignant arrhythmias to present as benign ones.
- Emphasizes the importance of comprehensive ECG lead analysis for accurate diagnosis.
- Underscores the need for vigilance in differentiating ventricular tachycardia from atrial flutter.