" Seizure " in a 60 year old male

This 60 yo male had an apparent tonic clonic seizure.  He had no history of seizures.  He was unconscious for 8 minutes and slowly awoke in the ambulance, complaining of nausea only.  First responders found him to bevery tachycardic, confused, perserverating and with no memory of the event.  There was tongue biting.  Lightheadedness continued.The tachycardia was gone by the time paramedics arrived.He had a prehospital ECG:What do you think?Interpretation.  There is terminal T-wave inversion in V2, highly suggestive of Wellens ' pattern.  But syncope or seizure alone, without chest pain, is not enough to call it Wellens syndrome.  There might also be some subtle ST depression, suggestive ofde Winter orPrecordial Swirl pattern.Without chest pain, the pretest probability is not very high.Here is the Queen ' s interpretation (the Queen always assumes a fairly high pretest probability of OMI):This version of the Queen (version 1) does not differentiate between active and reperfused OMI.  So she will call Wellens ' ECG " OMI " .With explainability:She also sees that terminal T wave inversion.__________YOU TOO CAN HAVE THE PM Cardio AI BOT!!  (THE PM CARDIO OMI AI APP)If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here.This is for the version housed on Telegram:https://share-eu1.hsforms.com/18cAH0ZK0RoiVG3RjC5d...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs