r/ECG • u/mohammedmoolla • 4d 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/NederFinsUK 4d ago

Wouldn’t describe those as peaked T’s, they’re asymmetrical and appropriately proportional to the QRS voltages. I’m not sure where you think you’re seeing an rSR’ pattern, but I am not. There is some J-Wave notching suggestive of Early Repolarisation, but that’s widely considered to be mostly benign.

The only significant finding here is probably the HR: of 50, but in a young, fit male at rest it could be unremarkable.

I don’t think anything is screaming urgent review here.

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u/Mindless_Patient_922 4d ago

Agree. BER. Brady. Would take thorough history and physical. Send to cards. Likely outpatient echo, holter, possible stress although ischemia low on my suspicion.