Wide complex tachycardia physical examination

Resident Survival Guide

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Wide complex tachycardia Microchapters
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Overview
Causes
Differentiating VT from SVT with aberrant conduction
Epidemiology and Demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Initial assessment of the ABCs (airway, breathing, and circulation) is critical in the management of the patient with wide complex tachycardia. Patients who are hemodynamically unstable should undergo immediate cardioversion.

Physical Examination

• Vitals should be obtained to assess hemodynamic stability and guide therapy.
• Cannon "a waves" are a manifestation of AV dissociation and suggest VT.
• Carotid sinus massage (CSM)/Valsalva: ST can gradually slow. MAT, AT, flutter, and AF may transiently slow. An AV nodal dependent WCT may terminate. AV dissociation may become more apparent with CSM in VT. VT can terminate with CSM.