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Wide Complex Tachycardia: Diagnosis And Management In The Emergency Department

W hen confronted with a wide complex tachycardia
(WCT), it is crucial to consider the differential
diagnosis, which includes both common and
uncommon entities. The common entities include
supraventricular tachycardia (SVT) with aberrant
ventricular conduction (AVC) and ventricular
tachycardia (VT). Less commonly encountered
processes include preexcited tachycardias (seen
in patients with Wolff-Parkinson-White [WPW]
syndrome) as well as toxic- and metabolicallymediated
WCTs (sodium channel blocker toxicity,
severe hyperkalemia).
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Emergency Presentation Of Congenital Heart Disease In Children

Though the field of antenatal ultrasound and
echocardiography has advanced considerably in
the last decade, many children with congenital heart
disease (CHD) are not diagnosed before birth and do
not manifest symptoms until after discharge from the
newborn nursery. 1-7 Frequently, when symptoms
develop, they are first brought to the attention of an
emergency medicine physician. These infants and
children are particularly challenging patients, often
appearing markedly distressed with non-specific
signs and symptoms that resemble more common
pediatric diagnoses such as sepsis, respiratory infection,
or reactive airway disease.
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