Wednesday, 10 February 2016

ECG of the Week - 8th February 2016 - Interpretation

The following ECG is from a 56 yr old female who presented with 3 hours of typical cardiac chest pain. The pain onset coincided with an episode of emotional distress.

Click to enlarge

  • 78 bpm
  • Sinus rhythm
  • Single PAC seen in leads V1-3
  • Normal
  • PR - Normal (~140ms)
  • QRS - Normal (100ms)
  • QT - 400ms (QTc Bazette 455ms)
  • ST Elevation leads aVR, V1, V2 - all <1mm
  • ST Depression leads II, III, aVF, V3-6

  • Prominent T waves leads I, II, aVL, V2-3

  • ST changes suspicious for ACS
  • The patient had ongoing chest pain and was taken for urgent angiography

What happened ?

The angiogram showed no coronary vessel disease but Takotsubo pattern cardiomyopathy.

Check out some great cases from Dr Smith's ECG blog on Takotsubo here:

Other resources

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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