The following ECG is from a 40-year-old man who presents overnight with left sided sharp chest pain which has woken him from sleep. He describes the pain as radiating into his left arm. He looks well from the end of the bed and his observations are unremarkable.
He has a past medical history which is significant for hypertension, hypercholesterolaemia and a strong family history of ischaemic heart disease.
What are the key abnormalities and how will you manage this patient?
The following ECG is from a 60 year old lady with chest pain and dyspnoea a few hours after finishing a triathlon. At the scene she was hypothermic at 32 degrees.
On arrival to ED she has no chest pain but ongoing dyspnoea and her temperature has normalised.
This is her initial ECG, what are the key abnormalities and how will you manage the patient?
With thanks to Dr Lorna Cronin for ECG and answer.
71 y old male is coming with palpitations, haemodynamically stable.
This ECG represents fever induced Brugada syndrome.
Needs aggressive treatment of the fever and Cardiology referral for ICD.
Additional information from LITFL:
Brugada Syndrome Key Points
51 year-old-man with 3 days history of fevers, productive cough, malaise, chest pain and a syncopal episode. His ECG is:
This ECG is typical posterior MI with deep horizontal STD in V1-V3. Patient was transferred to SCGH cathlab priority 1, loaded with Aspirin 300 mg and Heparin 5000 U iv as per their cardiology advice.
61-year-old non-English speaking lady from India. Presented with chest pain for few hours.
What is the spot diagnosis?
What else would do in this case?
The main finding is prolonged QT interval.
Use Bazett formula to calculate QTc. In this case 516 msec
QTc is prolonged if:
35-year-old lady with palpitations. Her ECG as below.
ECG of the Week 1 February 2023 – Interpretation