An approach to the patient with a suspected tachycardia in the emergency department

Abstract

Patients present to the emergency department with either an ongoing tachycardia or a history suspicious of a tachycardia. Either way, the tachycardia needs to be documented, preferably on a 12-lead electrocardiogram (ECG) for diagnosis and management. If a tachycardia is not documented, a careful history of the palpitations should be taken to see if further monitoring and investigations are required. If a tachycardia is confirmed on an ECG, the clinician needs to classify it according to two variables: (i) regularity of the rhythm; and (ii) QRS width. This will allow a differential diagnosis to be made.

Topic reviews need to be robust

“…The final edition provided an evidence-based and pragmatic approach to chest pain and acute coronary syndromes [9] and suspected tachyarrhythmias in the emergency room. [10] Upon this background, the main goals of the HF review were to: (i) emphasise how to make the diagnosis of HF; (ii) highlight clues for recognition of the underlying aetiology of HF; (iii) review the pathophysiology of HF; and (iv) provide a simplified approach to management of HF.…”

Cardiovascular medicine in primary healthcare in sub-Saharan Africa: Minimum standards for practice (part 3)

“…The current edition provides an evidence-based and pragmatic approach to acute coronary syndromes and chest pain, [13] and suspected tachyarrhythmias in the emergency room. [14] Pandie et al [13] discuss the approach to chest pain and acute myocardial infarction. The history and physical examination are the mainstay of clinical assessment, and are complemented by a 12-lead electrocardiogram (ECG) and cardiac biomarkers for correct diagnosis.…”