{"id":9824,"date":"2008-11-13T01:12:32","date_gmt":"2008-11-13T01:12:32","guid":{"rendered":"http:\/\/cardiophile.org\/?p=566"},"modified":"2024-01-20T11:44:48","modified_gmt":"2024-01-20T06:14:48","slug":"ecg-quiz-21-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/","title":{"rendered":"Narrow QRS Tachycardia with ST Depression"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/6QwxdSMRvZU?si=AI_bDW54OrAsXrYM\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">ECG Quiz 21<\/span><\/h2>\n<figure id=\"attachment_26760\" aria-describedby=\"caption-attachment-26760\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-26760 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia.jpg\" alt=\"ECG Quiz 21\" width=\"900\" height=\"464\" \/><figcaption id=\"caption-attachment-26760\" class=\"wp-caption-text\">ECG Quiz 21<\/figcaption><\/figure>\n<p>A narrow QRS tachycardia is seen at a rate of around 150\/min. ST segment depression is seen in inferior and lateral leads, with T wave inversion in leads I, aVl and V6. These ST &#8211; T changes during tachycardia need not indicate associated coronary artery disease. It is quite common in supraventricular tachycardia even in young individuals. It could be a manifestation of a prominent Ta wave which is the atrial repolarization wave. Another situation in which Ta wave becomes prominent and produces ST segment change is during exercise test. The upsloping ST segment depression seen during exercise test has low specificity for coronary artery disease due to this. In this case there is evidence of left ventricular hypertrophy which can also contribute to the ST &#8211; T changes.<\/p>\n<p>The rate of 150\/min should make us suspect atrial flutter at a rate of 300\/min with 2:1 conduction as the underlying cause. Carotid sinus massage can reduce the conduction rate and bring out flutter waves in a doubtful case.\u00a0\u00a0In this case no features of flutter waves are evident. Instead there is a suggestion of a retrograde P wave at the end of the QRS in inferior leads. This will qualify for the description of a short RP tachycardia. Two important differential diagnoses of short RP tachycardia are AVNRT and AVRT.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECG Quiz 21<\/p>\n","protected":false},"author":1,"featured_media":17633,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[2531,3788],"class_list":["post-9824","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library","tag-narrow-qrs-tachycardia","tag-supraventricular-tachycardia"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG Quiz 21<\/title>\n<meta name=\"description\" content=\"ECG Quiz 21\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG Quiz 21\" \/>\n<meta property=\"og:description\" content=\"ECG Quiz 21\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2008-11-13T01:12:32+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-01-20T06:14:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"900\" \/>\n\t<meta property=\"og:image:height\" content=\"464\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Narrow QRS Tachycardia with ST Depression\",\"datePublished\":\"2008-11-13T01:12:32+00:00\",\"dateModified\":\"2024-01-20T06:14:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/\"},\"wordCount\":236,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2008\\\/11\\\/short-rp-tachycardia1.jpg\",\"keywords\":[\"narrow QRS tachycardia\",\"Supraventricular tachycardia\"],\"articleSection\":[\"ECG \\\/ Electrophysiology\",\"ECG Library\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/\",\"name\":\"ECG Quiz 21\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2008\\\/11\\\/short-rp-tachycardia1.jpg\",\"datePublished\":\"2008-11-13T01:12:32+00:00\",\"dateModified\":\"2024-01-20T06:14:48+00:00\",\"description\":\"ECG Quiz 21\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#primaryimage\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2008\\\/11\\\/short-rp-tachycardia1.jpg\",\"contentUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2008\\\/11\\\/short-rp-tachycardia1.jpg\",\"width\":900,\"height\":464},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-21-2\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Narrow QRS Tachycardia with ST Depression\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ECG Quiz 21","description":"ECG Quiz 21","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/","og_locale":"en_US","og_type":"article","og_title":"ECG Quiz 21","og_description":"ECG Quiz 21","og_url":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2008-11-13T01:12:32+00:00","article_modified_time":"2024-01-20T06:14:48+00:00","og_image":[{"width":900,"height":464,"url":"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg","type":"image\/jpeg"}],"author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"Narrow QRS Tachycardia with ST Depression","datePublished":"2008-11-13T01:12:32+00:00","dateModified":"2024-01-20T06:14:48+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/"},"wordCount":236,"commentCount":0,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#primaryimage"},"thumbnailUrl":"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg","keywords":["narrow QRS tachycardia","Supraventricular tachycardia"],"articleSection":["ECG \/ Electrophysiology","ECG Library"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/","url":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/","name":"ECG Quiz 21","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#primaryimage"},"thumbnailUrl":"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg","datePublished":"2008-11-13T01:12:32+00:00","dateModified":"2024-01-20T06:14:48+00:00","description":"ECG Quiz 21","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#primaryimage","url":"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg","contentUrl":"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/11\/short-rp-tachycardia1.jpg","width":900,"height":464},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-21-2\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"Narrow QRS Tachycardia with ST Depression"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/9824","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=9824"}],"version-history":[{"count":4,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/9824\/revisions"}],"predecessor-version":[{"id":62195,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/9824\/revisions\/62195"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media\/17633"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=9824"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=9824"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=9824"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}