ECG of the Week – 5th February 2018 – Interpretation

By | 7 februari 2018

The following ECG is from a 35 yr old male who presented with 1 hour of central severe chest pain. He has a past medical history of Type 2 Diabetes and a positive family history. He had recently been unwell with a febrile illness.



Click to enlarge


Rate:

  • 120 bpm

Rhythm:

  • Regular 
  • Sinus rhythm 

Axis:

  • Normal / Inferior

Intervals:

  • PR – Normal (~170ms)
  • QRS – Normal (80ms)
  • QT – 270ms (QTc Bazette 380 ms)

Additional:

  • ST Elevation leads I (, II (1mm)
  • Baseline artifact limits in precordial leads
  • ST Elevation leads V1-3 (<=1mm)
  • T waves in right precordial leads look prominent
  • Relative high voltages in right precordial leads
  • Absence of ST depression
Interpretation:
  • Sinus tachycardia
  • ST segment changes without reciprocal changes

DDx

  • Benign Early Repolarisation
  • Pericarditis
  • ACS – should always be considered when making a diagnosis of pericarditis

The patient underwent a bedside echo which was normal without evidence of pericardial effusion or regional wall motion abnormality.
He was subsequently treated as pericarditis with symptomatic improvement.

References / Further Reading

Life in the Fast Lane

Textbook

  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.

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ECG of the Week – 5th February 2018 – Interpretation

By | 7 februari 2018

The following ECG is from a 35 yr old male who presented with 1 hour of central severe chest pain. He has a past medical history of Type 2 Diabetes and a positive family history. He had recently been unwell with a febrile illness.



Click to enlarge


Rate:

  • 120 bpm

Rhythm:

  • Regular 
  • Sinus rhythm 

Axis:

  • Normal / Inferior

Intervals:

  • PR – Normal (~170ms)
  • QRS – Normal (80ms)
  • QT – 270ms (QTc Bazette 380 ms)

Additional:

  • ST Elevation leads I (, II (1mm)
  • Baseline artifact limits in precordial leads
  • ST Elevation leads V1-3 (<=1mm)
  • T waves in right precordial leads look prominent
  • Relative high voltages in right precordial leads
  • Absence of ST depression
Interpretation:
  • Sinus tachycardia
  • ST segment changes without reciprocal changes

DDx

  • Benign Early Repolarisation
  • Pericarditis
  • ACS – should always be considered when making a diagnosis of pericarditis

The patient underwent a bedside echo which was normal without evidence of pericardial effusion or regional wall motion abnormality.
He was subsequently treated as pericarditis with symptomatic improvement.

References / Further Reading

Life in the Fast Lane

Textbook

  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.

Geef een reactie