A 36-year-old female nurse comes to the clinic due to a sensation of fast hea rate, slight dizziness, and vague chest fullness. Blood pressure is 110/70. The following rhythm strip is obtained, which shows
## **Core Concept**
The patient's symptoms of a fast heart rate, dizziness, and chest fullness, along with the provided rhythm strip, suggest a cardiac arrhythmia. The electrocardiogram (ECG) rhythm strip is crucial for diagnosing various cardiac arrhythmias. The description points towards **supraventricular tachycardia (SVT)**, a condition characterized by a rapid heart rate originating above the ventricles.
## **Why the Correct Answer is Right**
The correct answer, **.**, corresponds to an ECG rhythm strip showing **atrioventricular nodal reentrant tachycardia (AVNRT)**, a common type of SVT. AVNRT is characterized by a narrow complex tachycardia (QRS duration < 120 ms) with a rate typically between 150-250 beats per minute (bpm), and often presents with symptoms like palpitations, dizziness, and shortness of breath. The ECG shows a regular rhythm with P waves usually hidden within the QRS complex or visible as a pseudo-S wave in lead II.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option does not match the description of AVNRT or other SVTs based on typical ECG presentations.
- **Option B:** This option might represent a different type of arrhythmia, such as atrial fibrillation, which is characterized by an irregularly irregular rhythm and variable QRS complexes, not matching the patient's symptoms and regular rhythm.
- **Option C:** This could potentially represent a different arrhythmia but does not align with the classic presentation of AVNRT.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that **AVNRT can often be terminated with vagal maneuvers** such as the Valsalva maneuver or carotid massage, which temporarily block AV nodal conduction. This is both a diagnostic clue and a therapeutic approach.
## **Correct Answer: .**