ECG of the Week - 3rd September 2018 - Interpretation

The following ECG is from a 69 year old male who presented to the Emergency Department after an episode of abnormal limb movement.

Click to enlarge

Rate:

• 66 bpm

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Normal

Intervals:

• PR - Normal (~200ms)
• QRS - Normal (105ms)
• QT - 400ms

Additional:

• Dominant R wave leads V2-3
• T wave inversion leads I, aVL, V2-6
• ST Depression leads I, II
• ST elevation V2-3

What happened ?

The patient's had known findings apical hypertrophic cardiomyopathy, sometimes referred to as Yamaguchi Syndrome. He was investigated for a potential neurological cause of abnormal limb movement and discharged for ongoing out-patient follow-up.

You can read more about apical hypertrophic cardiomyopathy in the links below:

• Life in the Fast Lane - Hypertrophic Cardiomyopathy
• Madias JE. Electrocardiogram in apical hypertrophic cardiomyopathy with a speculation as to the mechanism of its features. Neth Heart J. 2013 Jun;21(6):268-71. PMID:23686564
• Yıldırım MN, Selçoki Y, Eryonucu B. Apical Hypertrophic Cardiomyopathy. Eur J Gen Med 2010;7(2):206-209

References / Further Reading

Textbook

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