30-year old Thai male presenting with syncope. Describe the ECG.

TOP 100 ECG QUIZ LITFL 028 2

Describe and interpret this ECG

ECG ANSWER and INTERPRETATION

ECG Findings

The patient is in sinus rhythm with no evidence of dysrhythmia or AV block.

The QT interval is normal and there is no evidence of WPW syndromeHOCM or ARVD.

There is a characteristic pattern of abnormalities in V1-2:

  • RSR’ pattern / partial RBBB
  • ST elevation with a “coved” morphology
  • Inversion of the terminal portion of the T wave

In a patient presenting with syncope, this ECG is diagnostic of the Brugada syndrome.


CLINICAL PEARLS

Syncope ECG Checklist

When faced with a patient presenting with syncope, systematically assess the ECG for the following abnormalities (click each item for details):

Too Fast?
Pump Failure
Syncope Syndromes
Electrical Problems

TOP 100 ECG SERIES


Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

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