What is the most likely arrhythmia in a patient with chest pain and wide QRS complexes?

In patients presenting with chest pain accompanied by wide QRS complexes, ventricular tachycardia is the most likely arrhythmia. Wide QRS complexes indicate that there is a disturbance in the conduction pathways, typically associated with ventricular rhythms. Ventricular tachycardia originates from the ventricles and results in rapid heartbeats that can compromise cardiac output and lead to significant symptoms such as chest pain.

This arrhythmia is often a sign of underlying cardiac issues, such as ischemia or structural heart disease, which can present as chest pain. The rapid and potentially life-threatening nature of ventricular tachycardia necessitates urgent evaluation and treatment to prevent progression to more severe complications like ventricular fibrillation or sudden cardiac arrest.

Other arrhythmias mentioned, such as sinus tachycardia, atrial flutter, and bradycardia, either do not normally present with wide QRS complexes or are less likely related to acute chest pain in the context of significant underlying heart conditions. Thus, ventricular tachycardia is the most plausible choice in this scenario.