Clinical Case Database / Category: Patient Management

Diagnosis of broad complex tachycardias

Publication details

Fozia Zahir Ahmed, ZR Estabragh, M Mamas, AM Zaidi, B Clarke
Foundation Years Journal, volume 8, issue 2, p.26 (123Doc Education, London, February 2014)


In the vast majority of cases broad complex tachycardias [BCTs] are due to ventricular tachyarrhythmias, however they may also result from aberrantly conducted supraventricular tachycardias [SVTs]. Accurate diagnosis of BCTs is important and challenging. Differentiation should be based on clinical assessment, 12-lead ECG and the response to drugs. Haemodynamic compromise is not a reliable distinguishing feature. SVTs respond to AV nodal [AVN] blockade whereas VT does not. Furthermore, verapamil may precipitate haemodynamic collapse or death in patients with VT and should be avoided. Where the diagnosis is unclear or when faced with haemodynamic instability the patient should be treated as having VT. The aim of this article is to provide a step-by-step approach for diagnosing BCTs.

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Fozia Zahir Ahmed

Specialist Registrar in Cardiology
Department of Cardiology, Manchester Heart Centre
Manchester Royal Infirmary,
Oxford Rd, Manchester, M13 9WL

ZR Estabragh

Manchester Royal Infirmary,
Oxford Rd, Manchester, M13 9WL

M Mamas

Manchester Royal Infirmary,
Oxford Rd, Manchester, M13 9WL

AM Zaidi

Manchester Royal Infirmary,
Oxford Rd, Manchester, M13 9WL

B Clarke

Manchester Royal Infirmary,
Oxford Rd, Manchester, M13 9WL


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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