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

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

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

  • 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

Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.