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12 Lead ECG Interpretation Course
By Dr. Vernon Stanley
Try It! Lesson of the WeekImage of Dr. Vernon Stanley
Test Your ECG I.Q. Tracing #185    [ Submit answer below illustration ]
You are working as a paramedic and are asked to evaluate a 42-year-old female with complaints of seizure activity. Her 12-lead is as shown below and your differential diagnosis would be as follows: ... (choose only one)
Tracing of the Week (Tracing #185)
A. Hypokalemia.
B. The patient is at risk for polymorphic ventricular tachycardia (Torsades de Pointes).
C. P-wave height suggestive of Right Atrial Enlargement (RAE).
D. Diffuse ST depression and biphasic T-waves consistent with ischemia. However, these changes are non-specific and might be simply secondary to the prolonged QT pattern.
E. Hypomagnesemia.
F. If the patient has recurrent syncopal episodes and a sibling died of sudden cardiac death at age 36 years, treatment mode possibilities should include a beta blocker and an automatic implantable defibrillator.
G. History of seizure disorder with negative work-up. Patient might be experiencing transient episodes of ventricular tachycardia (Torsades) as a result of QT prolongation.
H. Bazett's Equation reveals a QTc in excess of 500 msec. This represents QT prolongation and the patient is at risk for Torsades de Pointes.
I. QT prolongation consistent with tricyclic overdose. The patient is at risk for sudden death.
J. All of the Above.