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[Ventricular tachycardia masquerading as supraventricular tachycardia]
J Tomcsányi1, M Somlói, J Tenczer
1Országos Korányi Tbc és Pulmonológiai Intézet, Budapest.
Orvosi Hetilap
|December 16, 1998
Summary
Distinguishing supraventricular tachycardia from ventricular tachycardia can be challenging, even with pre-existing bundle branch block. Ventricular tachycardia can mimic supraventricular tachycardia, leading to potential misdiagnosis.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Differentiating supraventricular tachycardia (SVT) with aberrancy from ventricular tachycardia (VT) is clinically significant.
- Preexisting bundle branch block (BBB) often simplifies this differentiation; identical QRS morphology suggests SVT, while different morphology suggests VT.
Observation:
- Two cases of wide-complex tachycardia in patients with pre-existing BBB are presented.
- In both cases, the QRS morphology during tachycardia was nearly identical to the QRS morphology at rest.
Findings:
- Despite similar QRS morphology, findings such as atrioventricular dissociation and response to adenosine and lidocaine strongly indicated VT.
- These cases demonstrate VT masquerading as SVT due to identical QRS morphology in the context of BBB.
Implications:
- Identical QRS morphology during wide-complex tachycardia in BBB patients does not exclude VT.
- Careful evaluation for AV dissociation and response to specific medications is crucial to avoid misdiagnosis of VT as SVT.