The differentiation of Broad QRS complex tachycardias is a commonly encountered diagnostic dilemma in the emergency department. Patients presently with Broad QRS complex tachycardias are usually uncomfortable or have some form of hemodynamic distress requiring urgent attention. The electrocardiographic differential diagnosis includes ventricular tachycardia, supraventricular tachycardia with functional aberration, preexisting bundle branch block, intraventricular conduction disturbances, pre-excitation and effect of medications. Despite all available criteria, Broad complex tachycardias are still misdiagnosed or under diagnosed. With the rising prevalence of coronary artery disease in developing countries this diagnostic dilemma will be more frequently encountered in sub-Saharan African countries than previously. This paper will review some of the distinguishing features and recognized criteria.

Heart diseases occur in all age groups but the prevalence and pattern differs according to age, geographical region and socioeconomic status. Echocardiography is a non-invasive, relatively cheap imaging technique for evaluation of heart disease with reliable levels of accuracy. The aim of this study is to determine the prevalence and pattern of heart disease in our setting using echocardiography. Retrospective analysis of echocardiographic reports of heart diseases was done for age, sex and echocardiographic diagnoses. The mean age of the population was 47.76±19.45 years. Males were 122 and females were 109. Seventy two subjects (32.1%) had hypertensive heart disease, 53(22.9%) had dilated cardiomyopathy, 36(15.6%) had rheumatic heart disease, 15(6.5%) had ischemic heart disease, 10(4.3%) had pericardial diseases, 9(3.9%) had congenital heart disease, 2(0.9%) had corpulmonale. Others included 6 isolated right ventricular dilatation, 1 isolated left atrial dilatation and 1 hypertrophic cardiomyopathy in 3.5%. Forty echocardiograms17.3% were reported as normal. Hypertensive heart disease was the most prevalent heart disease in this study followed by those due to infections. The rising prevalence of ischemic heart disease shows that Nigeria is undergoing epidemiologic transition. Primary preventive measures, control of blood pressure and early treatment of infections is therefore recommended.

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