A 36-year-old female with history of alcohol abuse presents with nausea, vomiting and palpitations. Her ECG is shown on page 12 (ECG 30.2).
a) What is the major abnormality in this ECG? (20% marks)
b) List three differential diagnoses for the ECG abnormality. (20% marks)
a) What is the major abnormality in this ECG (20% marks)
b) List 3 differential diagnoses for the ECG abnormality (20% marks – 5% marks each)
- Electrolyte abnormality
- Drugs (many)
o E.g. Amitriptyline, amiodarone, erythromycin, droperidol, haloperidol, risperidone,
- Thyroid – hypo/hyper
- Myocardial – heart failure, ischaemia, myocarditis
This ECG is on loan from the Jill Squires collection, with many thanks to her. The QTc of this patient was 585 msec according to the automated QT-correcting algorithm.
Differentials, according to Harrigan & Chan (2009), include:
Drugs (also see www.qtdrugs.org)
Harrigan, Richard A., and Theodore C. Chan. "| What is the ECG differential diagnosis of a prolonged QT interval?." Critical Decisions in Emergency and Acute Care Electrocardiography. Oxford, UK: Wiley‐Blackwell, 2009. 479-482.