Broad QRS complex tachycardias in the emergency department: a review of distinguishing features

Abstract

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.