Paramedic Education at Monroe Community College, Rochester, New York

This 60 year old male patient with a history of hypertension and myocardial infarction 2 years ago walks in to your ambulance base complaining of mild fatigue and rapid heartbeat. He says that this has been going on for two days. He does not want to go to his physician or the hospital because they will keep him in. He just came in to get his BP checked. You check his BP and find it to be 116/80 and notice a pulse of 155. He is Cx and alert. Eyes: Perl, Neck: no JVD or cannon A waves, his chest is clear bilaterally to auscultation, his heart is regular, rapid and S1 S2 are well heard no R/M/G, his ABD: is flat, soft, and nontender EXTREM: =pulses no edema, MAE well. He has no allergies and takes 1 aspirin and 1 Lopressor each day. You ask him if you may obtain a 12 lead electrocardiogram on him and he aggrees. Here is the 12 lead that you obtain:

image

Your diagnosis, based on the story, physical findings, and EKG should be:
(Click "answer" below.)

A) This man is in Ventricular Tachycardia

B) This man is in SVT with abberation

C) This man is in Sinus Tachycardia with a Right Bundle Branch Block

D) This man is in SVT with Left Bundle Branch Block


* ANSWER

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Updated: February 26, 1998
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