Widespread ST elevation leads I, II, III, aVF, V2-6
ST Depression lead aVR
PR depression leads I, II, III, aVF, V4-6
PR elevation lead aVR
Down-sloping T-P segment best seen in lead II
Note sinus tachycardia - ? effusion
What happened ? The patient was admitted under the cardiology team. Blood tests showed a negative troponin but raised inflammatory markers and D-dimer. A subsequent CTPA showed a pericardial effusion and the patient underwent pericardiocentesis for a large effusion, total drainage of ~900mls of fluid ! The ultimate diagnosis was of viral pericarditis complicated by pericardial effusion.
This ECG is from an 80 yr old male who presented with a 1 weeks worth of chest pain. Complex past medical history with significant cognitive impairment. Multiple medications but nil sodium channel blocking agents. Check out the comments on our original post here.
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PR - Normal (~200ms)
QRS - Normal (80ms)
QT - 340ms (QTc Bazette 390 ms)
Up-sloping ST elevation V2-4
Biphasic T wave leads V2-4
T wave inversion lead I, aVL
Wellens' pattern T wave / ST changes
What happened ? The patient had raised ischemic biomarkers, however given the severity of his co-morbidities nil further intervention was performed. An ECHO showed concentric left ventricular hypertrophy with posterior wall akinesis.