Approach to ECGs - Syncope Syndromes

Electrolytes

 • ↑K - brady, peak T, wide QRS, no P, sine wave, "the great imitator"

 • ↓ K - ST dep, T inv, U wave, long P

 • ↑ Ca - short QT, Osborn J (see below)

 • ↓ Ca - long QT via long ST

 • ↑ Mg - assoc with 1K, AV block

 • ↓ Mg - long QT, assoc withlK

Brugada 1 - Coved STE >2mm in >1 of V1-V3 + negative T

WPW - delta wave and short PR

HOCM- dagger Q lat>inf leads, LVH, LAE, giant T inversion precordial

ARVD - epsilon wave, T wave inversion, QRS widening/prolonged S wave V1-V3

Trifascicular block - RBBB, LAFB/LPFB (see below), 1st degree heart block

Long QT (>480-500ms)

Short QT (<360ms)

PE: RBBB, S1Q3T3, tall R in V1, RAE, RV strain (neg TV 1-V4)



- Dr. Michael Wong @mchlwng



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