Friday, 25 January 2013

ECG of the Week - 28th January 2013

This week's ECG was kindly donated by @UnaNicI. It's from a 45 year old male.

Click to enlarge


  1. The list of differential diagnoses would include:
    1. Myocardial ischemia/Wellens' warning
    2. Benign T-wave inversion / Early repolarization
    3. CNS disease
    4. Myocarditis
    5. Electrolyte disturbance
    6. Subacute/old pericarditis
    7. Myocardial contusion
    8. Myocardial infarction
    9. Drug effect

  2. Rate: 65bpm
    Regularity: regular w/o ectopy
    P-waves: sinus, 1:1 association
    PRi: normal
    QRSd: ~100ms

    Rhythm: normal sinus rhythm

    Axis: normal, probably ~45deg
    QTi/QTc: borderline
    ST/T-waves: no elevation, however, deeply symmetric T-wave inversion in the precordials and flat ST-segments with terminal T-wave inversion in I and aVL.

    DDx: normal sinus rhythm with Wellens T-waves from a recently reperfused LAD; also on the list for me is CNS insult; don't know that I'd include BTWI in a 45yo M (or at least not in the field).

    As always Jason has a pretty comprehensive list to choose from after you've worked thru the #1 and #2 lethal ones.