A 17 year old female presents to ED complaining of chest pain and SOB on a background of ILI symptoms for the last 2 days. Vitals: HR 138 BP 110/70 Temp 37.7 RR 24. Below is the patients ECG:

Describe and Interpret the ECG:

Answer

Rate: 120

Rhythm: Sinus tachycardia

Axis: Normal Axis

Intervals:

PR: 160ms

QTc: 353

QRS: 80ms

Additional:

T wave inversion II, III and aVF and V3-6

The above ECG shows a sinus tachycardia with T wave inversion inferolaterally.  In the clinical context this might be related to a myopericarditis. Rate related ischaemia is another likely cause. PE should be considered but less likely in this clinical context.