ECG of the Month: Wide Complex Tachycardia in an Adult Patient with Surgically Corrected Congenital Heart Disease

Abstract

A 27-year-old man with history of hypoplastic left-sided heart syndrome, status post-Fontan palliation surgery, and depressed right-sided ventricular function presented to the emergency department with acute-onset chest pain and shortness of breath while walking up steps to his home 90 minutes before presentation. He was ill appearing and diaphoretic on arrival. He was alert but had delayed capillary refill and perioral cyanosis. His initial vital signs were significant for pulse rate of 204 beats/min, respiratory rate of 22 breaths/min, blood pressure 132/75 mm Hg, and oxygen saturation of 88% on 3 L of nasal cannula oxygen.