Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sudden onset of palpitations, lightheadedness, and near-syncope. ECG demonstrates polymorphic ventricular tachycardia with varying QRS morphology and axis. History significant for [prolonged QTc / electrolyte disturbance / structural heart disease]. No prior history of sustained ventricular arrhythmias.
Clinical Examination Findings
General: Patient appears distressed, diaphoretic, and hemodynamically [stable/unstable]. Cardiovascular: Tachycardic, irregular rhythm, S1/S2 present, no murmurs. Pulses: Peripheral pulses weak and rapid. Neurological: Alert and oriented, no focal deficits noted.
Treatment Protocol
Immediate management: If hemodynamically unstable, perform synchronized cardioversion. If stable, correct reversible causes (electrolytes, ischemia). Administer IV Magnesium Sulfate (2g bolus) if Torsades de Pointes suspected. Consider antiarrhythmic therapy (e.g., Amiodarone, Lidocaine) and evaluate for urgent ICD implantation or catheter ablation.