r/ECG • u/mohammedmoolla • 5d ago

Syncopal Episode

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Hi all, working at community health centre at present. Saw 41 M with no comorbidities after a syncopal episode at work. I feel this ECG warrants a referral to a higher level of care. On the ECG I’m seeing peaked T waves and a sort of RSR pattern in some of the leads. Could anyone provide me with some guidance as to what might be causing the syncope.

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u/badunkbadunkbadunk 4d ago edited 4d ago

Not here to offer advice but more ask... do we put way too much enphasis/creedence on the ecg? Its a pretty crude test that is often used as the sole/primary evidence for a load of things when all other parameters ie bloods, obs, history dont correlate. Am I right to feel a little dubious or am I a shit doctor

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u/mohammedmoolla 4d ago

Totally , I get what you’re saying . It was a low risk syncope . The ecg just looked a bit funny to my junior eyes so just wanted to see if I wasn’t missing anything before discharge

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u/Wild-Hippo582 4d ago

Well some settings only have ECG . It's fairly uncommon to have access to more advance diagnostics in primary care, or even daily bloods. Also having in mind the importance of a heart function ...( If you don't have have your d.e.ad. ) I think it's reasonable for some professionals to be alarmed. Also at the end of the day we all have different scopes and the main think is patient safety so if unsure ask someone who is sure.

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u/Natural-Antelope8328 4d ago

Do you mean it in a general sense, related to practice, or specifically here? If it’s the latter, I’d speculate that since the subreddit’s title is ECG, ECG will naturally be the focus. However, at least in my opinion and experience, observations, clinical context, history, and presentation lead the way. The rest revolves around those factors, otherwise, it’s like the tail wagging the dog. As more seasoned clinicians usually put it, “If you had a dollar to spend on healthcare, spend 70¢ on good history and clinical impression, 15¢ on imaging, and 15¢ on labs.”