Abstract
The many dysrhythmic vagaries of a single patient illustrate several practical points in the diagnosis of arrhythmias that bear emphasis because they are often not appreciated: The physical examination can provide useful information that is not available from the electrocardiogram; a right chest lead is superior for continuous monitoring, and a left chest lead is sometimes valuable for distinguishing between ventricular and supraventricular tachycardias; ventricular aberration of one bundle branch type may abruptly switch to aberration of the other bundle branch type; and advanced atrioventricular (A-V) block with accelerated ventricular rhythm can be simulated by A-V tachycardia with 2:1 exit block and aberrant ventricular conduction. The practical significance of these facts is discussed.
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