Wednesday, 13 August 2014

ECG of the Week - 11th August 2014 - Interpretation

This ECG is from an 80 yr old male who presented with a 1 weeks worth of chest pain.
Complex past medical history with significant cognitive impairment. Multiple medications but nil sodium channel blocking agents.
Check out the comments on our original post here.

Click to enlarge

  • 78
  • Regular
  • Sinus rhythm
  • Normal
  • 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
What happened ?

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.

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