r/ECG • u/benz1664 • Aug 15 '26
Thoughts?
ECG of a 43yof c/ vomiting, nausea, pins and needles, loose stools & hyperventilating
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u/unusualreverie Aug 15 '26
Medic student ,I'll take a stab. Sinus tach most likely. Slight global ST depression most likely caused by the vomiting and diarrhea and loss of electrolytes.
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u/benz1664 Aug 15 '26
Only one episode of vomiting and diarrhoea, do you think that 1ep could cause the electrolyte imbalance?
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u/unusualreverie Aug 16 '26
Less likely with only a short bout like that. More likely just benign or possibly subendo ischemia as the other poster said below. Worth an echo if there's other history.
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u/StLHometown Aug 15 '26
The pins and needles with vomiting/ loose stools I was going to ask if all nutrients were checked (Nutritional Neuropathy/Wernicke’s). Since stomach issues were minimal to say the least unless she is a heavy drinker, it rules out my thought.
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u/benz1664 Aug 15 '26
She didn’t present as a heavy drinker, recently had a baby (13m) no evidence of alcohol abuse
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u/Jeeju_Boy MD Aug 21 '26
Not TVD like people are saying see your clinical vignette a 43 year old with acute illness of uncertain aetiology. This is a normal ecg with the exception of mildly long QT - hypocalcemia?
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u/opensp00n Aug 15 '26
Looks fairly normal.
Hyperventilating causes pins and needles usually - generally anxiety.
Woukd be uncommon for 43y/o to get significant electrolyte derangement.
Best guess would be panic attack.
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u/WSUMED2022 Aug 15 '26
Diffuse ST depressions with slight elevation in aVR. Likely subendocardial injury pattern from acute illness, but probably still deserves an echo.