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An Extreme Wide-Complex Tachycardia and Tremors
Samuel Kim1, Sukhmandeep Sangha1, Srisa Boddupalli1
1Wollongong Hospital, Wollongong, Australia; University of Wollongong, Wollongong, Australia.
JACC. Case Reports
|July 30, 2026
Summary
Graves
Area of Science:
- Cardiology
- Endocrinology
Background:
- Wide-complex tachycardia (WCT) can be challenging to diagnose.
- Hyperthyroidism is a potential, yet often overlooked, cause of cardiac arrhythmias.
Purpose of the Study:
- To highlight the association between Graves' disease and wide-complex tachycardia.
- To emphasize the importance of screening for hyperthyroidism in patients with tachyarrhythmias.
Main Methods:
- Case presentation of a 33-year-old male with syncope, palpitations, and tremors.
- 12-lead electrocardiogram (ECG) revealing wide-complex tachycardia at 300/min.
- Diagnosis confirmed by ECG, biochemical testing (hyperthyroidism), and electrophysiology study.
Main Results:
- Patient diagnosed with hyperthyroidism secondary to Graves' disease.
- Urgent cardioversion successfully managed the acute tachyarrhythmia.
- Electrophysiology study and ablation provided definitive treatment.
Conclusions:
- Differential diagnosis for WCT includes ventricular tachycardia, supraventricular tachycardia with aberrancy, pre-excitation, or pacing.
- Hyperthyroidism should be considered a precipitating and reversible cause of tachyarrhythmias.
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