The World’s Okayest Medic Podcast Yes, That Wide Complex Tach is Probably VT
Aug 29, 2025
Delve into the complexities of diagnosing ventricular tachycardia, where misdiagnoses can have serious implications. The discussion emphasizes the need for emergency providers to confidently identify VTAC in symptomatic patients. Listeners learn about historical perspectives and current algorithms for differentiating wide complex tachycardias. It’s a deep dive into critical decision-making that can save lives, making it a must-listen for those in the medical field.
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VT Is The Most Likely Cause
- Up to 85% of wide complex tachycardias are ventricular tachycardia (VT).
- This makes VT the most likely cause when you see a fast, broad QRS rhythm.
Teaching Moment With A Cardiologist
- Mike recalls paramedics bringing a clear VT case and a cardiologist dismissing criteria discussion in front of students.
- That encounter reinforced trusting symptomatic presentation over strict reliance on concordance rules.
Act On Context—Treat Sick Patients As VT
- Treat symptomatic, sick patients with new wide complex tachycardia as VT unless you know a clear alternative.
- If unstable, prepare for electricity and start antiarrhythmic therapy per protocols.