ECG post-treatment of hyperkalaemia (serum potassium 5.2 mmol/L) …
DESCRIPTION:
- Ventricular rate 91 bpm
- Sinus rhythm
- PR interval 132 ms
- Normal QRS axis 38°
- QRS duration 110 ms
- ST segment elevation aVR, V1-2
- Upsloping ST segment depression in leads I, II, III, aVF, V4-6
- Normalised T wave morphology
- QTc 501 ms
INTERPRETATION:
Sinus rhythm with persistent ST segment and T wave changes despite resolution of hyperkalaemia. Highly suspicious for ongoing diffuse subendocardial ischaemia, severe triple vessel disease, proximal LAD occlusion, or subtotal occlusion of the LMCA.
CASE PROGRESSION:
High-sensitivity Troponin I peaked at 25000 ng/L, however due to the patient’s significant co-morbidities a decision was made to treat his acute coronary syndrome conservatively.
