The following ECG is from a 12 yr old male who presented to the Emergency Department following an episode of palpitations and near-syncope. he has no past medical history.
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- 66 bpm
- Sinus rhythm
- PR – Short(~100ms)
- QRS – Prolonged (120ms)
- QT – 360ms (QTc Bazette 380 ms)
- T wave inversion leads aVR, aVL, V1
- Biphasic T wave in lead V2
- Delta wave best seen in leads I,V2-4
- Notching initial portion of QRS in leads II, III, aVF
- Wolff-Parkinson-White (WPW) Syndrome
- Pre-excitation evidence by PR shortening, QRS prolongation and Delta Waves
What happened ?
Given the history of near syncope with palpitations the patient was admitted under paediatric cardiology for monitoring of likely tachyarrhythmia.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.