Author: Steve Corry-Bass / Editor: Andrew Tabner / Reviewer: Andrew Tabner, Haitham Hodhod / Codes: ACCS LO 1, CC1, CC3, CP1, CP3, RP3, RP7, SLO3, SLO6 / Published: 07/02/2020

A 33-year-old male presents to the emergency department (ED) with a one hour history of feeling as though his heart is racing. Over the past 10 minutes he has started to develop some discomfort in the centre of his chest. Recently he has had some diarrhoea and vomiting. He has no other symptoms. He looks pale and clammy.

He has no significant past medical history and takes no regular medications.

Observations:

Temp – 36.4oC

HR – 193/minute

RR – 21/ minute

Sats – 99% (room air)

BP – Unable to record (cuff cycling)

His ECG is shown:

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