ECG Case 037

15-year old patient presenting with rapid palpitations and dizziness. Symptoms resolved en route to hospital. Describe the ECG.

TOP 100 ECG QUIZ LITFL 037 2

Describe and interpret this ECG

ECG ANSWER and INTERPRETATION

Main Abnormalities

This ECG is diagnostic of the Wolff-Parkinson-White (WPW) syndrome:

Other Features:

  • Dominant S wave in V1 — this “type B” pattern indicates a right-sided accessory pathway.
  • Tall R waves and inverted T waves mimic the appearance of LVH — this is an electrical phenomenon due to WPW and not a sign of ventricular hypertrophy.
  • ST segments and T waves show typical “discordant” changes — they point in in the opposite direction to the QRS complex, similar to LBBB.

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 |

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