EM Alliance ECG – Case 13

67yom CP. 3 yrs Hx of CP on exertion. CP on rest for 1/12.

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

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4 Comments Add yours

  1. Tatsu Kuwasaki says:

    Andrew sent me txts & he was spot on with his interpretation for the Wallen’s Syndrome.
    I think many of you are familiar with its significance but here is the link from LIFL.

    https://lifeinthefastlane.com/ecg-library/wellens-syndrome/

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  2. Andrew O says:

    Well Tatsu your update certainly changes things…

    The occlusion patterns in V2 & V3 certainly suggest there’s a more acute problem in the septal aspects.. This in combination with the dodgy looking complexes and ST segments in the precordial leads suggest there’s a couple of structural and electrical problems going on.

    Whatever is going on I’d be inclined to suggest it’s probably IHD or long term vessel disease, and were now seeing factors which are the culmination of it…

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  3. Tatsu Kuwasaki says:

    OK, the ECG shown was when Pt had chest pain, and the following is another ECG taken when there was no pain…

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  4. Andrew O says:

    What happened to him 3 years ago?
    It looks like he’s got a structural heart problem that’s getting worse, causing inadequate coronary perfusion.

    Double spike in QRS V2 and the equivoltage of Q &S in lead III point towards an inferior/septal disease process to me… I’m not sure if the wide QRS in V2 constitutes a U wave or not, but it might back up my theory…

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