The ECG shows group beats in which the last beat is a PVC and the others are sinus beats (shown as “S”).
The first step in the ECG interpretation is determining the rhythm. so first look for p waves. the best leads for recognizing the p waves are lead II and V1. if you can’t see P waves in these leads, look at all the leads. in this strip P waves are visible in the lead V3. Note that some of P waves are hidden behind the prior T waves.

#case178 ❤️

38 y male with palpitation and chest pain

The correct answer is “Ventricular tachycardia”

ECG features suggesting VT:
• AV dissociation
• qR pattern in lead aVR with q wave >40ms
• Taller left rabbit ear

this arrhythmia is an example of idiopathic fascicular Ventricular tachycardia which is characterized by features of VT and the followings:
• QRS duration 100 – 140 ms. this is narrower than other forms of VT
• Short RS interval (onset of R to nadir of S wave) of 60-80 ms. the RS interval is usually > 100 ms in other types of VT
• RBBB Pattern
• Axis deviation depending on anatomical site of re-entry circuit

#case179 ❤️

35 y male with palpitation

The correct answer is “Atrial tachycardia”

There is a narrow complex tachycardia at a rate of ~160 . each QRS complex is preceded by an abnormal p wave (inverted in the inferior leads, upright in aVR). occasional AV block is also present.

#case180 ❤️

80 y female KCO:IHD with dyspnea and hypotension

The correct answer is “Cardiac tamponade”

The ECG shows beat-to-beat alterations in the height of QRS complexes reflecting the swinging of the heart in the pericardial fluid(electrical alternans). This finding in combination with Hypotension suggest cardiac tamponade.
other classic findings of tamponade including Low voltage complexes and tachycardia are not present