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

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5 Comments Add yours

  1. Tatsu Kuwasaki says:

    Is anyone concerned about the big Q waves?

    Like

    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…”
      https://lifeinthefastlane.com/ecg-library/pre-excitation-syndromes/

      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)
      http://hqmeded-ecg.blogspot.co.nz/2012/03/wpw-mimicking-and-obscuring-acute-stemi.html

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

      Like

    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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