The Curbsiders Internal Medicine Podcast #473 Rapid Response Series: Narrow Complex Tachyarrhythmias with Dr. Noble Maleque
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Mar 3, 2025 In this engaging discussion, Dr. Noble Maleque, an associate professor at Emory University, dives into the complexities of narrow complex tachyarrhythmias. He emphasizes the importance of timely interventions and effective collaboration with cardiology. Listeners will learn about EKG interpretation, physical maneuvers like the modified Valsalva, and medication strategies involving adenosine and beta blockers. The conversation also touches on personal anecdotes, including Dr. Maleque's fascination with watches, blending medical insights with a touch of personal charm.
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Initial Steps in Rapid Response for Tachycardia
- When responding to a rapid response page for tachycardia, ask the nurse about the patient's current status and vital signs.
- Request an EKG, establish IV access, and gather information about the patient's prior condition.
Defining Stable vs. Unstable Tachycardia
- Defining stable vs. unstable tachycardia is crucial for guiding treatment.
- Consider hemodynamics (hypotension, tachypnea, hypoxemia), symptoms (chest pain, shortness of breath, altered mental status), and provider comfort level.
Narrow Complex Tachycardia Assessment
- For stable narrow complex tachycardia (QRS < 120ms or 3 small boxes), determine if it's sinus tachycardia or not.
- This differentiates the etiology and guides management.