This post is an answer to ECG Case 267
- Rate: ~185 bpm
- Rhythm:
- Regular
- No atrial activity visible
- Axis: Extreme / NW Axis
- Intervals:
- QRS – Normal (80ms)
- QT – 260ms
- Segments:
- ST Elevation in leads I, aVL, V1
- ST Depression in leads II, III, aVF, V2-6
- Additional:
- Late R wave transition
- High voltages in infero-lateral leads with deep S waves
Interpretation
Narrow complex tachycardia in patient with cardiovascular compromise
What happened next ?
Prior to DC cardioversion the patient was treated with oxygenation, iv volume replacement and adenosine bolus with resultant reversion to sinus rhythm. The ST changes resolved rapidly following cardioversion and were likely due to demand ischaemia.
The patients resting ECG showed extreme axis deviation with persisting high inferior QRS voltage and deep S waves. The patient was admitted to hospital for management of his multiple medical issues and social situation.
READ MORE: ECG Interpretation – All you need to know
