Eponymous Cardiac Syndromes

Wellens Syndrome

SyndromePathologyECG
WellensProximal critical stenosis of LAD arterySymmetrical deeply inverted T waves in V2-3 or Biphasic in V2-3 with minimal ST elevation.Changes occur in pain free state and normalise when pain
BrugadaSodium channelopathy. 40% familial (autosomal dominant). Risk of sudden death, mandates urgent ICDRBBB with ST elevation in V1-3. Convex and concave ST variants
Wolff-Parkinson WhitePre-excitation syndrome.Re-entrant bundle of AV tissue distant to AV node.Short PR interval; Prolonged QRS and slurred upstroke of QRS complex (Delta wave).“Type A” shows positive QRS in V1 (LV accessory). Upright positive delta wave in all precordial leads with a resultant R greater than S amplitude in lead V1“Type B” shows negative QRS in V1(RV accessory). Predominantly negative delta wave and QRS complex in leads V1 and V2 and becomes positive in transition to the lateral leads resembling LBBB.
Mobitz II (Hay Block)A-V block. PR of constant intervalConstant PR interval until P waved dropped with P-P interval twice normal
Mobitz I (Wenckebach)A-V block. PR of increasing intervalLengthening PR interval until P waved dropped with P-P interval variable. Grouped beats
Lown-Ganong-LevinePre- excitation syndrome. Re-entrant bundle of AV tissue close to AV nodeAccessory pathway is down James fibres.No Delta wave as conduction normal down Bundle of His
Romano -WardInherited Long QT syndrome (Autosomal dominant). Defect of Na and K channels. Not associated with deafnessLong QT, T wave alternans, notched T wave, R on T phenomenon, Torsades
Jervell and Lange-Nielsen SyndromeInherited Long QT syndrome. Autosomal recessive defect of Na and K channels. Associated with neurosensorial deafness.Long QT , T wave alternans, notched T wave, R on T phenomenon, Torsades
Sgarbossa criteriaDerived from GUSTO 1 trial to identify MI in paced or LBBB patientsST elevation >1mm concordant with QRS complex (5pts), ST depression >1mm in V1-3 (3pts), ST elevation >5mm discordant with QRS 2 points. >3 points consistent with MI
Tako TsuboCardiomyopathy with hypertrophic LV inferior and Hypotrophic superior wall (Octopus jar heart)ECG changes as MI but usually brought on by stressful event

LITFL Further Reading


ECG LIBRARY 700

ECG LIBRARY

Electrocardiogram