This post is an answer to the ECG Case 263
- Rate: 90 bpm
- Rhythm: Sinus Arrhythmia
- Axis: Normal
- Intervals:
- PR – Normal (~200ms)
- QRS – Normal (100ms)
- QT – 400ms (QTc Bazette 380-400 ms)
- Segments:
- ST Elevation in leads V1 (2mm), V2 (2-2.5mm), aVR (1mm)
- ST Depression in II, III, aVF, V5-6
- Additional:
- Voltage criteria LVH
- S wave V1 + R wave V5 = 24mm + 14mm = 38mm
- Left Arial Enlargement
- Voltage criteria LVH
Interpretation
- LVH
- ST changes proportional to S wave voltage
- ST to S wave ratio <25%
What happened next ?
In this case the changes due to LVH were thought to represent acute MI and the patient was taken for urgent angiography which was essentially normal.
READ MORE: Left Ventricular Hypertrophy (LVH): How to Recognize it on ECG [With Examples]
SIMILAR CASES:
