Friday, 12 October 2012

ECG of the Week - 15th October 2012

This week's ECG is the first part of a two part story. 
This ECG is from a 33 year old male, don't know why he presented.




Click to enlarge

3 comments:

  1. Sinus rhythm with ventricular preexcitation; Wolff-Parkinson-White (W-P-W) syndrome. Localization of the accessory pathway (AP) is probably in the left lateral (LL) or left anterolateral (LAL) free wall.

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  2. Agree. looks like WPW, with short PR and delta wave. High R waves in precordial leads with T wave inversion also inferiorly wld suggest right ventricular hypertrophy, Raf

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  3. Agree with everything said before.

    Rate: ~70 bpm
    Regularity: Regular
    P-waves: Sinus
    PRi: Short
    QRS: Widening of intrinsicoid deflection

    Rhythm: NSR

    12-Lead:
    - Short PR
    - Slurred intrinsicoid deflection consistent with a delta wave
    - Tall R-waves in V1
    - QTc seems short-normal
    - Pseudo Q-wave in aVL
    ...and...
    - Secondary repolarization abnormalities
    or
    - Primary ST-elevation aVL/aVR
    - With ST-depression II/III/aVF/V4/V5

    DDx: NSR w/ WPW (left sided), with some potential for acute changes from LWMI worth obtaining serial ECGs to rule out.

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