Unread Pre-Discharge ECG
Report:
Sinus rhythm 58/min
Left axis deviation - 50o
Intraventricular conduction defect (IVCD)
Probably LAHB + non-specific conduction delay
Possible LVH
Giant anteroseptal T wave inversion
Prolonged QT interval 0.660”
(QTc for 58/min 0.45”)
Comment:
The T wave inversion may have been caused by syncope, perhaps mediated by an arrhythmia, or previous LBBB conduction. She was readmitted with multiform VT, probably a torsade de pointes, requiring a countershock (Fig 184a below).
A timely look at the pre-discharge ECG could have saved her some trouble. Sotalol is the likely culprit for the QT prolongation and the arrhythmia. The subject has been repeatedly reviewed134.
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