This post is an answer to the ECG Case 336
- Rate: 78 bpm
- Rhythm: Regular sinus rhythm
- Axis: Normal
- Intervals:
- PR – Normal
- QRS – Normal
- QT – 440ms (QTc Bazette 465 ms)
- Additional:
- ST Elevation in leads V1-3, I, aVL
- ST depression in leads III and aVF
- T wave inversion leads I, aVL, V1-6
Interpretation
- Features suggestive of ACS
- Pain-free patient on arrival to ED
- Only complained of dyspnea
- DDx:
- Reperfusion / Wellens
- Cardiomyopathy
What happened next ?
Following urgent cardiology consult the patient was taken for angiography. There was no evidence of vessel disease but appearance was typical for Takotsubo cardiomyopathy likely secondary to exertional stress from triathlon.
What are the potential complications of endurance sports ?
- Injury
- Rhabdomyolysis
- Dehydration
- Acute renal failure
- Myocardial strain
- Studies have shown raised troponin’s in marathon runners
- ACS
- Environmental illness
- Hypothermia
- Hyperthermia
- Hyponatraemia
- SIADH
- Water ingestion
- Hypoglycaemia
- Takotsubo
SIMILAR CASES:
