Holter Ischæmia
Report:
Top:
Sinus tachycardia 105/min
SVEB
ST/T changes suggestive of ischæmia
Middle:
Sinus rhythm 80/min
Resolving ST/T changes
Bottom:
Sinus rhythm 66/min
Isoelectric ST segments
Comment:
This is a good example of spontaneous ischæmia (at 3.30 a.m.). A clue that the ST segment shift is not artefactual – e.g., positional – is that the QRS size and orientation are constant. Also the time of day (i.e., night).
No significant arrhythmias were detected. What was causing her falls? Arrhythmia cannot be ruled out unless falls in sinus rhythm are documented; ischæmia (presumably silent) is now a possibility. It could be relieved by angioplasty19. However, in a 90 year old lady, other causes of falling down abound.
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