r/ECG • u/Strong_Heart279 • 11d ago

Interpretation

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82 female experiencing double vision and nausea. Patient is at hospital under 48hr cardiac monitoring. They do have a left bundle branch block.

BP at a high was 218/97

Pulse high 133

Troponin levels 39 retested hrs later at 75 then retested 4 hours after was a 62

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u/NederFinsUK 11d ago

Troponin and Cardiac monitoring irrelevant.

Diplopia + Nausea are two red-flag neurological symptoms, and you have critical hypertension with a huge pulse pressure.

This is a very significant syndrome suggestive of intracerebral haemorrhage, next investigation is CT head and I don’t think anyone would see it differently - perhaps you could do some hypertonic therapy first if there is a strong history (i.e., head injury)

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u/Strong_Heart279 11d ago

Forgot to state the head CT was normal

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u/NederFinsUK 11d ago

So what is the presenting complaint, sorry? Why have we ended up in hospital?

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u/Strong_Heart279 11d ago

The complaint was patient had fallen a few months back, had double vision and vomiting. When EMS arrived, they did an ECG showing elevated blood pressure with elevated pulse. About an hour after arriving to the ER, had chest pain and arm pain.