Thursday, June 30, 2016

Pace Yourself


This EKG is from a patient with a dual chamber pacemaker that presents to the emergency room with presyncope. The resident says, "It's a paced rhythm, we can't interpret it."

Challenge: But you reply, "The patient's presyncope is from...what?"

Image shown under Fair Use.

2 comments:

Anonymous said...

what's the diagnosis??

Craig Chen said...

Pace Yourself

This patient is having an inferior MI. There is markedly elevated J point elevation and convex ST elevation in the inferior leads with reciprocal changes. Although ventricular paced EKGs are not usually interpretable for ischemia, a >5mm ST segment elevation in right precordial or inferior leads are highly suggestive of ischemia.

Source: ECG Wave Maven.