tag:blogger.com,1999:blog-549949223388475481.post7879011819256226380..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Syncope During Exercise in a 12-Year OldUnknownnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-549949223388475481.post-3454575405237794352016-05-25T10:23:30.831-05:002016-05-25T10:23:30.831-05:00Very sad. Thanks.Very sad. Thanks.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-37798489246496749132016-05-24T11:53:11.607-05:002016-05-24T11:53:11.607-05:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-81161418922505194632016-05-24T04:46:24.766-05:002016-05-24T04:46:24.766-05:00Interesting case. I had a similar one some years ...Interesting case. I had a similar one some years ago with an 8 year old patient. His anomalous coronary artery caused a large MI while playing basketball, resulting in a VF/VT arrest. Unfortunately he passed away two weeks after the incident due to complications of ECMO while on the heart transplant list.PFRussellhttps://www.blogger.com/profile/10974675638245787009noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-54540729074862422222016-05-23T15:00:05.664-05:002016-05-23T15:00:05.664-05:00DR smith,
really interesting ,young boy with dizzi...DR smith,<br />really interesting ,young boy with dizziness on exercise ass with palpation makes us raise suspicion of arrhythmia and doing ECG is mandatory in any patient regardless his age .<br /><br />I guess I see a positive epsilon wave in V1 (AM I right ?) which raise the suspicion of ARVD. WHY echo and \or MRI is not done ? <br /><br />and if really the case was ANOMALOUS LEFT MAIN with ischemic changes , what is nthe role of cath lab here?<br /><br />regard.<br />khalidAnonymoushttps://www.blogger.com/profile/12852380081794106666noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-22095694352542062022016-05-23T13:38:52.014-05:002016-05-23T13:38:52.014-05:00GREAT case for a number of reasons. Most syncope/p...GREAT case for a number of reasons. Most syncope/presyncope episodes in otherwise healthy children and adolescents are not due to a potentially serious cardiac disorder. But it is essential for us to recognize those few times when a potentially life-threatening cardiac abnormality is present. This case highlights one of those times. Specifically, an “alarm” should go off in each of us from the history that was obtained during transport — namely, that this 12-year old girl “recalls running when she suddenly became dizzy and fell”. Syncope during exercise = automatic referral for full evaluation!<br /><br />With all the recent attention directed at recognizing Brugada patterns — there is a tendency to equate the rSr’ patterns seen here in leads V1,V2 with Brugada. As per Dr. Smith — this ECG does not manifest a Brugada pattern. Even if lead placement turned out to be accurate in this case — the r’ in both V1,V2 is very narrow with rapid descent down to the baseline. That is normal. In contrast, with Brugada-1 or -2 (Saddleback) findings — this angle measured from the peak of the r’ ( = the ß-angle) is wide.<br /><br />Finally — there is ST-T wave depression in inferior and lateral chest leads. In addition to the biphasic T wave appearance which is distinctly abnormal — the distribution of these ST-T wave changes is completely different than the anterior T wave inversion so commonly seen with juvenile T wave variant patterns.<br /><br />THANKS for presenting this case!<br /><br />ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.com