Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sustained palpitations, lightheadedness, and presyncope. ECG confirms wide-complex tachycardia with consistent QRS morphology, suggestive of monomorphic ventricular tachycardia. No evidence of polymorphic features or polymorphic QRS axis variation. Patient denies recent chest pain, dyspnea, or syncope. History significant for [Insert Structural Heart Disease/Prior MI].
Clinical Examination Findings
Cardiovascular: Tachycardic, regular rhythm, S1/S2 present. No murmurs, rubs, or gallops. Peripheral pulses are weak but symmetric. Jugular venous distension (JVD) noted. Lungs: Clear to auscultation bilaterally. Extremities: No peripheral edema. Neurological: Alert and oriented, no focal deficits.
Treatment Protocol
Immediate management: Hemodynamic stability assessment. If unstable: Synchronized cardioversion. If stable: Pharmacological intervention with IV Amiodarone or Procainamide. Electrolyte repletion (K+, Mg2+). Consider urgent electrophysiology (EP) study and potential catheter ablation for recurrent episodes. Long-term management: Beta-blocker titration and ICD evaluation.