eMedicine Specialties > Emergency Medicine > Cardiovascular

Ventricular Fibrillation: Differential Diagnoses & Workup

Author: Keith A Marill, MD, Faculty, Department of Emergency Medicine, Massachusetts General Hospital
Coauthor(s): A Antoine Kazzi, MD, Chair and Medical Director, Department of Emergency Medicine, American University of Beirut, Lebanon; Mazen K Khalil, MD, Post Doctoral Research Fellow, Department of Cell Biology, Lerner Research Institute, Cleveland Clinic Foundation; Aaron Bright, MD, Staff Physician, Department of Emergency Medicine, University of Southern California Keck School of Medicine
Contributor Information and Disclosures

Updated: Jul 28, 2008

Differential Diagnoses

Hyperkalemia
Toxicity, Digitalis
Hypokalemia
Ventricular Tachycardia
Torsade de Pointes
Toxicity, Antidepressant
Toxicity, Cocaine

Other Problems to Be Considered

Ventricular flutter
Wide complex tachycardia
Supraventricular tachycardia
Pulseless electrical activity (PEA)
Digitalis toxicity
Electrolyte disturbances
Acute pulmonary disorders
Acute toxidromes (eg, cocaine toxicity)

Workup

Laboratory Studies

  • Serum electrolyte levels, including calcium and magnesium
  • Cardiac enzymes to identify myocardial injury
  • Complete blood count (CBC) to detect contributing anemia
  • Arterial blood gases (ABGs) to assess degree of acidosis or hypoxemia
  • Toxicologic screens and levels as clinically indicated

Imaging Studies

  • Chest radiography may identify aspiration pneumonia, pulmonary edema, cardiomegaly, and injury (eg, secondary to cardiopulmonary resuscitation [CPR]).

Other Tests

  • Electrocardiography (ECG) to help identify ischemic or proarrhythmic conditions 

More on Ventricular Fibrillation

Overview: Ventricular Fibrillation
Differential Diagnoses & Workup: Ventricular Fibrillation
Treatment & Medication: Ventricular Fibrillation
Follow-up: Ventricular Fibrillation
Multimedia: Ventricular Fibrillation
References

References

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Further Reading

Keywords

VF, ventricular fibrillation, sudden cardiac death, SCD, tachycardia, ventricular tachycardia, VT, pulseless electrical activity, PEA, asystole, acute cardiac ischemia, acute cardiac infarction, acute myocardial infarction, MI, cardiac arrest

Contributor Information and Disclosures

Author

Keith A Marill, MD, Faculty, Department of Emergency Medicine, Massachusetts General Hospital
Keith A Marill, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

A Antoine Kazzi, MD, Chair and Medical Director, Department of Emergency Medicine, American University of Beirut, Lebanon
A Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Mazen K Khalil, MD, Post Doctoral Research Fellow, Department of Cell Biology, Lerner Research Institute, Cleveland Clinic Foundation
Mazen K Khalil, MD is a member of the following medical societies: American College of Physicians
Disclosure: Nothing to disclose.

Aaron Bright, MD, Staff Physician, Department of Emergency Medicine, University of Southern California Keck School of Medicine
Disclosure: Nothing to disclose.

Medical Editor

Steven A Conrad, MD, PhD, Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center
Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gary Setnik, MD, Chair, Department of Emergency Medicine, Mount Auburn Hospital; Assistant Professor, Division of Emergency Medicine, Harvard Medical School
Gary Setnik, MD is a member of the following medical societies: American College of Emergency Physicians and National Association of EMS Physicians
Disclosure: Intellicare Salary Management position; South Middlesex EMS Consortium Salary Management position

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Charles V Pollack, Jr, MD, MA, FACEP, Professor, Department of Emergency Medicine, University of Pennsylvania College of Medicine; Chairman, Department of Emergency Medicine, Pennsylvania Hospital
Charles V Pollack, Jr, MD, MA, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: sanofi-aventis Honoraria Consulting; sanofi-aventis Honoraria Speaking and teaching; Schering-Polugh Honoraria Consulting; Schering-Plough Honoraria Speaking and teaching; The Medicines Company Honoraria Consulting; GlaxoSmithKline Grant/research funds Other

 
 
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