This post is an answer to the ECG Case 236
- Rate: 60 bpm
- Rhythm: Sinus arrhythmia
- Axis: Normal
- Intervals:
- PR – Short (100ms)
- QRS – Prolonged (140ms)
- QT – 400ms (QTc Bazette 400 ms)
- Segments:
- ST Elevation in leads aVR, V1-4
- ST Depression in leads I, II, III, aVF, V5-6
- Additional:
- Voltage criteria for LVH
- Delta waves best seen infero-laterally
Interpretation
- Wolff-Parkinson-White Syndrome
- ST segment changes proportional and discordant to QRS direction
- Anteroseptal pathway (Arruda Algorithm)
What happened next ?
The patient had known WPW and serial ECG’s and biomarkers were negative and he was referred for an out-patient provocation test.
READ MORE: Atrial Fibrillation in the Wolff-Parkinson-White (WPW) Syndrome
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