A 20-something woman with cardiac arrest.

The patient is a 20 something female. She is healthy with no known cardiac disease. She was admitted to the neurology department due to headache and vomiting. She was found to have a viral CNS infection. A few days into her hospital stay she developedchest discomfort and the following ECG was recorded. What do you think? Why such large T-waves?  Are these hyperacute T-waves? Are these ECG changes related to the CNS infection perhaps? What disease processes would you put on your list of differential diagnoses?When I saw the ECG of this patient I saw that there was definitely something " off " . I didn ' t get the OMI feeling, but I did worry about the T waves. It was hard for me to precisely explain why it did not " feel " like an OMI. The ECG below was on file and was taken a few days earlier, on the day of admission to the hospital.This ECG is relatively normalThus, the first ECG above shows clear change from the ECG on admission, with more wide based T-waves inferiorly and laterally. The wider base of the T waves results in QTc prolongation. There is no ST-elevation. There is a massive inverted T wave in lead aVL. The T-waves have more area under the curve than baseline, but don ' t appear like typical hyperacute T waves. Are you worried about OMI in this case? Is this an inferior OMI with reciprocal T wave inversion i aVL? The chest pain quickly subsided. A troponin was drawn and the patient was put on telemetry monitoring.I sent the top ECG to Dr Smith...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs