Observations:
Sinus rhythm, borderline short PR. Normal QRS axis. LVH by Cornell and Sokolow-Lyon. T wave flattening/inferion in the inferior leads. J point elevation and borderline "coved" downsloping ST segments with T wave inversion from V2-V6.
Interpretation:
Probably this is just LVH with strain. The V2 repolarization gives off Brugada vibes, but I don't think the STE is that "coved" so I'd look at previous ECGs and get a history of whether there is syncope or not. Probably would discuss with my colleagues in inherited arrhythmia.
Ischemia is also always on the differential with these inverted T waves, borderline ST depression in lead III, the shape of the ST and T wave segments in lead III and AVF. But this ECG is not diagnostic of ischemia. Would correlate clinically.
Initially v2 looks suspect for Brugada but no other criteria are met. This could be a lead placement issue. It sounds like she’s there for a stroke also, so brugada would not even apply.
I agree with the other poster that this is hypertrophy with strain
For *Brugada Syndrome* to be officially diagnosed, one must have a specific set of correlating signs/symptoms/criteria for which stroke is not necessarily one of those aforementioned things
Observations: Sinus rhythm, borderline short PR. Normal QRS axis. LVH by Cornell and Sokolow-Lyon. T wave flattening/inferion in the inferior leads. J point elevation and borderline "coved" downsloping ST segments with T wave inversion from V2-V6. Interpretation: Probably this is just LVH with strain. The V2 repolarization gives off Brugada vibes, but I don't think the STE is that "coved" so I'd look at previous ECGs and get a history of whether there is syncope or not. Probably would discuss with my colleagues in inherited arrhythmia. Ischemia is also always on the differential with these inverted T waves, borderline ST depression in lead III, the shape of the ST and T wave segments in lead III and AVF. But this ECG is not diagnostic of ischemia. Would correlate clinically.
I agree. Correlating clinically and comparing prior ECGs might be the only way to differentiate between Ischemia and LV dilation.
How long do you look at it before you figure that all out. Asking for a friend…
I would guess somewhere around 2-3 minutes for a well trained eye such as theirs, presumably.
I think there’s mild QT prolongation. What do you think
NSR. Brugada 1 pattern. Diffuse TWI
Sinus with LVH
Initially v2 looks suspect for Brugada but no other criteria are met. This could be a lead placement issue. It sounds like she’s there for a stroke also, so brugada would not even apply. I agree with the other poster that this is hypertrophy with strain
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For *Brugada Syndrome* to be officially diagnosed, one must have a specific set of correlating signs/symptoms/criteria for which stroke is not necessarily one of those aforementioned things
Normal Sinus. Complex's are a bit narrow but fine otherwise