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.


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.