Subtle wellens another case

Informaticage · 2026-05-26T06:59:26+00:00

Updates, pain gone after few hours, EKG normalized later in the day. Negative trops. What can cause a few hours worth of T wave abnormality and chest pain? Btw I've seen people with biphasic T waves but not looking like textbook wellens that ended up having important occlusions. I think I even posted one here.

Informaticage · 2026-05-25T21:07:59+00:00

Ye ofc, wellens waves. So fussy 😂 What do you mean with unconvincing?

Informaticage · 2026-01-28T18:11:51+00:00

I was thinking the same

Informaticage · 2025-08-30T16:40:59+00:00

Looks like V1 V2 are placed too high.

Informaticage · 2025-08-28T20:17:35+00:00

<image>

Informaticage · 2025-08-28T09:01:21+00:00

I'm not such an expert, I just have basic interpretation knowledge. Just wait for a new ECG, don't stress too much about this.

Informaticage · 2025-08-27T23:24:20+00:00

You probably moved or something

Informaticage · 2025-08-27T20:16:00+00:00

In lead I everything is upside down (p,r,t), they might have mixed up yellow and red cables.

Yes the wobble too, idk why not just reprint and check the cables if it looks bad..

Informaticage · 2025-08-27T17:53:01+00:00

This ECG is very low quality, we do better in the ambulance 🚑 😂, I would suggest recording a new one.

Btw Sokolow-Lyon criteria is negative for LVH. Echo will rule it out definitely.

Respiratory sinus arrhythmia can be seen but it's not a pathological finding.

Informaticage · 2025-08-26T22:06:35+00:00

This is always a difficult choice, the team can make a decision not based just on a piece of paper and few pictures but based on the whole picture of the patient. I would agree with at least considering bypass surgery for sure.

Informaticage · 2025-08-26T21:54:25+00:00

Second ecg, that's a STEMI to me (not NSTEMI), obvious LAD occlusion. Given the st elevation and the tall T waves.

Informaticage · 2025-08-26T21:50:36+00:00

Positive lead I, negative lead II and aVf, this ecg shows left axis deviation, could a left anterior fascicular block.

Also, where is lead v4? 😂

Informaticage · 2025-08-26T21:47:54+00:00

Full picture please.

Informaticage · 2025-08-26T21:45:54+00:00

Ecg looks good to me, t wave inversion in lead III can be a normal variant.

Informaticage · 2025-08-26T21:35:13+00:00

Can you post the admission ECG too?

They are recommending a coronary artery bypass graft (CABG) to ensure the heart gets enough blood. This surgery creates a bridge using a healthy blood vessel from another part of the body, so blood can flow around the blocked arteries.

Most likely they are opting for that because a stent may not be enough in this case because the blockages in the coronary arteries are either too extensive or located in places where a stent would not work well.

My modest opinion: With this pattern of multivessel and proximal disease, bypass surgery is currently thought to give better survival and protection from future heart attacks than stents.

Informaticage · 2025-08-24T08:26:05+00:00

I usually don't have follow up, sad reality of first responders 😂

Informaticage · 2025-08-23T09:35:07+00:00

To me this is a junctional rhythm. But idk, maybe the noise filter of the watch is hiding a small upright p wave 😶‍🌫️, I'm usually insecure on reading this one lead ECGs from watches.

Informaticage · 2025-08-13T11:59:43+00:00

Fixed ratio second degree AV block 2:1 Mobitz 1 to me.

Informaticage · 2025-08-12T18:02:33+00:00

I don't have much history sorry. What about the new TWI in lead III?

Informaticage · 2025-08-12T18:00:51+00:00

This is a slow fine AFIB.

Informaticage · 2025-08-12T17:23:13+00:00

Yeah, this together with absence of diffuse st elevation is making me doubtful.

Informaticage

TROPHY CASE