When managing a patient with chest pain and dyspnea, what key EKG finding could suggest ventricular tachycardia as the diagnosis?

The key EKG finding that suggests ventricular tachycardia (VT) is the presence of wide complex tachycardia. In VT, the QRS complexes are typically wider than normal, generally greater than 120 milliseconds. This widening occurs because the electrical impulses in the ventricles are originating from an abnormal focus within the ventricular myocardium, leading to a slower conduction through the ventricles.

In contrast, narrow complex tachycardia typically indicates a supraventricular origin, where the impulses are conducted normally through the ventricles. The presence of P-waves would suggest atrial activity and is not characteristic of VT, as the ventricular rhythm often does not allow for synchronized atrial activity. An irregularly irregular rhythm is associated with conditions like atrial fibrillation, not ventricular tachycardia. Hence, the recognition of a wide complex tachycardia on an EKG is a critical aspect in diagnosing ventricular tachycardia when a patient presents with symptoms like chest pain and dyspnea.