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Case 4: Tachycardia and collapse in a bus driver
  1. David Lefroy
  1. Department of Cardiology, Hammersmith Hospital, London, UK

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A 53 year old bus driver became suddenly unwell with a feeling of collapse, but without loss of consciousness. The ambulance crew who were called to the scene detected a broad complex tachycardia and administered 100 mg lignocaine intravenously, but this had no effect. On arrival at hospital, he was conscious, but pale and clammy with a pulse of 210 per minute and a blood pressure of 120/50 mm Hg.

The patient had no previous history of cardiovascular disease. Apart from the presence of tachycardia, there were no abnormal cardiovascular signs.

The significance of these signs and symptoms, the diagnosis, and the short and long term treatment of these problems are discussed in an interactive case presentation.