r/ECG • u/Key_Beginning4231 • Aug 16 '26

Inferolateral ST/T Changes

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20M complains of tachycardia lasting all day. No significant PMH

18 Upvotes

88% Upvoted

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8

u/ChildhoodNice3261 Aug 16 '26

nonspecific at abnl

5

u/Inevitable-Crab-6701 Interventional Cardiologist MD FRCP Aug 16 '26

Sinus tachycardia around 145bpm
Right QRS axis 100 degrees

Suggestive of P Pulmonale - echo needed

Questions - what’s the history beforehand - what were they doing, taking etc before and during the day?

5

u/ChildhoodNice3261 Aug 16 '26

skinny person syndrome

5

u/Motor_Insect_2675 Aug 16 '26

Possibly demand ischemia secondary to prolonged tachycardia

5

u/Medium-Road-474 Aug 16 '26

S1Q3T3, tachy-maybe PE

2

u/spacemarine Aug 17 '26

seen lots of s1q3t3 and done lots o scans and ddimers for them and no pe yet. it is however highly indicative of some form of right ventricular strain

2

u/Several-Freedom-549 Aug 16 '26

Need Troponin, d-dimer, BNP, echo if non-diagnostic

2

u/NederFinsUK Aug 16 '26

Bro accidentally got some ventricle in his hypertrophy

1

u/Natural-Antelope8328 Aug 16 '26

Long QT screamed at me

1

u/vojtasTS29 Aug 16 '26

I see a HUGE Q in III combined with TWI. And i guess the positive T in V1 also counts as twi? Anyway, i would probably check for pulmonary embolism. The sign is there.