February 7, 2018
ECG of the Week – 5th February 2018 – Interpretation
The following ECG is from a 35 yr old male who presented with 1 hour of central severe chest pain. He has a past medical history of Type 2 Diabetes and a positive family history. He had recently been unwell with a febrile illness.
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Rate:
- 120 bpm
Rhythm:
- Regular
- Sinus rhythm
Axis:
- Normal / Inferior
Intervals:
- PR – Normal (~170ms)
- QRS – Normal (80ms)
- QT – 270ms (QTc Bazette 380 ms)
Additional:
- ST Elevation leads I (, II (1mm)1mm>
- Baseline artifact limits in precordial leads
- ST Elevation leads V1-3 (<=1mm)
- T waves in right precordial leads look prominent
- Relative high voltages in right precordial leads
- Absence of ST depression
Interpretation:
- Sinus tachycardia
- ST segment changes without reciprocal changes
DDx
- Benign Early Repolarisation
- Pericarditis
- ACS – should always be considered when making a diagnosis of pericarditis
The patient underwent a bedside echo which was normal without evidence of pericardial effusion or regional wall motion abnormality.
He was subsequently treated as pericarditis with symptomatic improvement.
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.
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