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A young man with tachycardia
  1. R Sivakumar,
  2. A Eltrafi,
  3. J H Silas
  1. Arrowe Park Hospital, Cheshire CH49 5PE, UK
  1. Dr Silas

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Answers on p 134.

A 30 year old man was admitted with palpitations of sudden onset. There was no history of previous episodes. He was a non-smoker, did not take excess alcohol or any recreational drugs, and there was no family history of ischaemic or any cardiac disorders. He was breathless and was hypotensive; his electrocardiogram is given below (fig 1).

Figure 1

Electrocardiogram of patient.

Questions

(1)
What is the differential diagnosis?
(2)
What is the most likely diagnosis?
(3)
How will you manage this patient acutely?
(4)
What is the long term management?

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