EM Alliance ECG – Case 9

OK, here is this month’s ECG from http://www.emalliance.org

22yom, syncope
Have a go and share your thoughts!

ECG courtesy of http://www.emalliance.org


5 Comments Add yours

  1. Tatsu Kuwasaki says:

    Is anyone concerned about the big Q waves?


    1. Tatsu Kuwasaki says:

      OK, you guys are all too smart to fall on this trap so…

      Yes, it’s WPW, and LIFL states;

      “Pseudo-infarction pattern (pathological Q waves look alike) can be seen in up to 70% of patients…”

      Just another note re: pathological Q waves used to be thought to take time to develop but it can occur after a couple of hours and it is not necessary the sign of “old infarct”.

      WPW mimicking and obscuring acute MI (Dr Smith’s ECG Blog)

      Hope you are enjoying this ECG series.
      Thanks for those brave enough to comment on the blog!


    2. Bev says:

      Agreed with others that it’s WPW. Delta waves are commonly seen in WPW with a negative deflection in inferior & anterior leads (in this case inferior leads III & aVF) which can resemble q waves & mimic an MI. These are known as Pseudo-Q waves & not a concern.

      Liked by 1 person

  2. geehannah says:

    WPW – short PR, broad QRS and delta wave .

    Liked by 2 people

  3. finnhurst says:

    Looks like wpw due short pr segment and delta wave.

    Liked by 1 person

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