• J Emerg Med · Mar 2017

    Case Reports

    An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

    • Maura Sammon, Alveena Dawood, Scott Beaudoin, and Richard A Harrigan.
    • Department of Emergency Medicine, Temple University, Philadelphia, Pennsylvania.
    • J Emerg Med. 2017 Mar 1; 52 (3): 348-353.

    BackgroundOne of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions.Case ReportWe describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions.Copyright © 2016 Elsevier Inc. All rights reserved.

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