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

Deze website gebruikt Akismet om spam te verminderen. Bekijk hoe jouw reactie gegevens worden verwerkt.

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

Deze website gebruikt Akismet om spam te verminderen. Bekijk hoe jouw reactie gegevens worden verwerkt.