title: Differentiating Types of Wide-Complex Tachycardia to Determine Appropriate Treatment in the Emergency Department.
abstract: Wide-complex tachycardia is a rare disease entity among patients presenting to the emergency department. However, due to its potential life-threatening nature, emergency clinicians must know how to assess and manage this condition. Wide-complex tachycardia encompasses a range of cardiac dysrhythmias, some of which can be difficult to distinguish and may require specific treatment approaches. This review summarizes the etiology and pathophysiology of wide-complex tachycardia, describes the differential diagnosis, and presents an evidence-based approach to identification of the different types of tachycardias through the use of a thorough history and physical examination, vagal maneuvers, electrocardiography, and adenosine. The treatment options and disposition for patients with various wide-complex tachycardias are also discussed, with attention to special circumstances and select controversial/contemporary topics.
authors: Associate Professor, Department of Emergency Medicine, SUNY Downstate Medicine Center/Kings County Hospital Center, Brooklyn, NY.
authors: Ian S
authors: IS
authors: deSouza
authors: Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Alanna C
authors: AC
authors: Peterson
authors: Research Faculty, Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Keith A
authors: KA
authors: Marill
mesh_terms: D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D004636:Emergency Service, Hospital; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D013610:Tachycardia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy