A 39-year-old woman presented to our emergency department with palpitations. She is known with premature atrial beats and a normal transthoracic echocardiogram. During the past year she developed palpitations, in particular following her pregnancy. Currently, she is not using any heart medication. Her family history was unremarkable. Her vital signs and physical exam were normal. Her initial ECG at the emergency department demonstrated a narrow QRS complex tachycardia of 186 beats per minute (Fig. 1). After 50 mg metoprolol, her heart returned to normal sinus rhythm (Fig. 2).
Fig. 1
Initial 12-lead ECG at the emergency department demonstrating a regular narrow QRS tachycardia
Fig. 2
The 12-lead ECG after metoprolol
×
×
Question
What is the mechanism of the narrow QRS complex tachycardia?
Answer
You will find the answer elsewhere in this issue.
Conflict of interest
S.C. Yap declares that he has no competing interests.w
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
