Complex past medical history with significant cognitive impairment. Multiple medications but nil sodium channel blocking agents.
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- Sinus rhythm
- PR - Normal (~200ms)
- QRS - Normal (80ms)
- QT - 340ms (QTc Bazette 390 ms)
- Up-sloping ST elevation V2-4
- Biphasic T wave leads V2-4
- T wave inversion lead I, aVL
- Wellens' pattern T wave / ST changes
The patient had raised ischemic biomarkers, however given the severity of his co-morbidities nil further intervention was performed.
An ECHO showed concentric left ventricular hypertrophy with posterior wall akinesis.
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.