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?"
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what's the diagnosis??
ReplyDeletePace Yourself
ReplyDeleteThis 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.