FOAMed question of the day 34 #FOAMedQOTD

Interpret the following ECG from a syncopal patient.




  1. Belinda Hibble says:

    WPW Type A

  2. SR 75/min, int axis, PQ 0,11 QRS 0,12, delta wave, QT normal. High voltages with downsloping-neg T in V1-4.
    WPW and old posterior MI or hypertrofy??

  3. Pre-excitation / accessory AV pathway / WPW Syndrome

    T-wave abnormalities in precordial leads could be part & parcel of a repoloraisation abnormality related to the accessory pathway and abnormal depolarisation, but in any other context would raise concerns about a proximal LAD or left main stenotic lesion (e.g. Wellen’s).

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