Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2015;68:892 - Vol. 68 Num.10 DOI: 10.1016/j.rec.2014.10.021

Echocardiographic Diagnosis of Ventricular Tachycardia

Paul M. Preza a,

a Servicio de Cardiología, Hospital Nacional Arzobispo Loayza, Lima, Peru

Refers to

Echocardiographic Diagnosis of Ventricular Tachycardia: Is There a Problem With Clinical and Electrocardiographic Diagnostic Criteria?
Pablo J. Sánchez-Millán, Manuel Molina-Lerma, Luis Tercedor-Sánchez, Miguel Álvarez-López
Rev Esp Cardiol. 2016;69:353-4
Full text - PDF

Article

A 60-year-old, hypertensive female with chronic coronary disease was seen at the Emergency Department after she had been suffering from palpitations for three hours with a heart rate of 159 bpm; she was haemodynamically stable and the rest of the physical examination did not provide further information. Electrocardiogram: heart rate 150 bpm, QRS axis –10°, P waves not visible, QRS 0.20 ms and complete left bundle branch block (Figure 1). After cardioversion, the electrocardiogram showed first degree atrioventricular block plus complete right bundle branch block and a heart rate of 50 bpm. Subsequent electrocardiograms showed first degree atrioventricular block plus complete left bundle branch block (Figure 1). Ventricular tachycardia was suspected due to the patient's history of ischaemic heart disease, but the electrocardiogram diagnosis was unclear. The diagnosis of the electrophysiologist was atrial tachycardia with aberrant conduction based on the absence of haemodynamic decompensation and the similarity of the complete left bundle branch block complexes with the wide QRS tachycardia complexes. We decided to implant a pacemaker and to increase the doses of the antiarrhythmic drugs amiodarone and beta-blockers. During the echocardiography, the patient presented with tachycardia without haemodynamic instability, and views of the atria and ventricles (Figure 2) were therefore taken in tissue M-mode via the subcostal window as well as an image that cut through the left atrium and right ventricle (Figure 3), establishing a diagnosis of VT, which was subsequently confirmed by remote pacemaker monitoring. The frequency of the episodes of ventricular tachycardia diminished with sotalol.

Figure 1.

Figure 2.

Figure 3.

1885-5857/© 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.