Eponymous Cardiac Syndromes
Syndrome | Pathology | ECG | |
Wellens | Proximal critical stenosis of LAD artery | Symmetrical 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 | |
Brugada | Sodium channelopathy. 40% familial (autosomal dominant). Risk of sudden death, mandates urgent ICD | RBBB with ST elevation in V1-3. Convex and concave ST variants | |
Wolff-Parkinson White | Pre-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 interval | Constant PR interval until P waved dropped with P-P interval twice normal | |
Mobitz I (Wenckebach) | A-V block. PR of increasing interval | Lengthening PR interval until P waved dropped with P-P interval variable. Grouped beats | |
Lown-Ganong-Levine | Pre- excitation syndrome. Re-entrant bundle of AV tissue close to AV node | Accessory pathway is down James fibres.No Delta wave as conduction normal down Bundle of His | |
Romano -Ward | Inherited Long QT syndrome (Autosomal dominant). Defect of Na and K channels. Not associated with deafness | Long QT, T wave alternans, notched T wave, R on T phenomenon, Torsades | |
Jervell and Lange-Nielsen Syndrome | Inherited 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 criteria | Derived from GUSTO 1 trial to identify MI in paced or LBBB patients | ST 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 Tsubo | Cardiomyopathy 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 Basics – Waves, Intervals, Segments and Clinical Interpretation
- ECG A to Z by diagnosis – ECG interpretation in clinical context
- ECG Exigency and Cardiovascular Curveball – ECG Clinical Cases
- 100 ECG Quiz – Self-assessment tool for examination practice
ECG LIBRARY
Electrocardiogram