CARDIOLOGY - ECG LIBRARY
Case 28
50 epigastric pain + vomiting. Feels lightheaded. B/G HTn + GORD
Expected Response
Polymorphic VT/Torsade de Pointes (must state this)
Extreme sinus Bradycardia (rate approx. 20 bpm)
Likely prolonged QTc
Ventricular ectopic ‘R on T’ phenomenon causing Torsades
DDx
Severe hypokalaemia/hypomagnesaemia secondary to vomiting
Use of QTc prolonging medication relevant to clinical scenario – anti-emetics, eg metoclopramide, ondansetron
Myocardial ischaemia, with epigastric pain an ACS equivalent presentatio
Extreme sinus Bradycardia (rate approx. 20 bpm)
Likely prolonged QTc
Ventricular ectopic ‘R on T’ phenomenon causing Torsades
DDx
Severe hypokalaemia/hypomagnesaemia secondary to vomiting
Use of QTc prolonging medication relevant to clinical scenario – anti-emetics, eg metoclopramide, ondansetron
Myocardial ischaemia, with epigastric pain an ACS equivalent presentatio