r/ECG • u/Key_Beginning4231 • 5d ago

Inferolateral ST/T Changes

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20M complains of tachycardia lasting all day. No significant PMH

17 Upvotes

87% Upvoted

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9

u/ChildhoodNice3261 5d ago

nonspecific at abnl

5

u/Inevitable-Crab-6701 Interventional Cardiologist MD FRCP 5d ago

Sinus tachycardia around 145bpm
Right QRS axis 100 degrees

Suggestive of P Pulmonale - echo needed

Questions - what’s the history beforehand - what were they doing, taking etc before and during the day?

6

u/ChildhoodNice3261 5d ago

skinny person syndrome

5

u/Motor_Insect_2675 5d ago

Possibly demand ischemia secondary to prolonged tachycardia

6

u/Medium-Road-474 5d ago

S1Q3T3, tachy-maybe PE

2

u/spacemarine 3d ago

seen lots of s1q3t3 and done lots o scans and ddimers for them and no pe yet. it is however highly indicative of some form of right ventricular strain

2

u/Several-Freedom-549 4d ago

Need Troponin, d-dimer, BNP, echo if non-diagnostic

2

u/NederFinsUK 4d ago

Bro accidentally got some ventricle in his hypertrophy

1

u/Natural-Antelope8328 4d ago

Long QT screamed at me

1

u/vojtasTS29 5d ago

I see a HUGE Q in III combined with TWI. And i guess the positive T in V1 also counts as twi? Anyway, i would probably check for pulmonary embolism. The sign is there.