A Very Interesting EKG...

[Cancer Slayer]

Hey guys, an intern in my group ran into a really intersting case today. I've removed all ID'ing information and wanted to see what you thought..... The patient is a 27 y/o M with reported heavy cocaine use over the years. He takes (2) Adderall XR 20 MG's everyday (40mg/day). This guy was told to follow up but never did. I'm having a hard time seeing what's wrong with his EKG.
Thanks for your time

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[EPADHA]

I hope this is not one of those what's wrong w/ my ECG posts:

Sinus bradycardia, incomplete RBBB..

If the axis was more right, I might have been concerned about ASD especially as the PR interval is also borderline (close to 200 ms)..

 

[BrakngLyv]

Your group hires interns?

 

[CanIMakeIt]

I hope this is not one of those what's wrong w/ my ECG posts:

Sinus bradycardia, incomplete RBBB..

If the axis was more right, I might have been concerned about ASD especially as the PR interval is also borderline (close to 200 ms)..

Agreed. What do you make of borderline low voltage in limb leads?

 

[intcards]

The ST segments in V1 and V2 are not isolelectric and have a saddleback appearance. This is suggestive if Brugada type 3 pattern, which can be induced by cocaine. Low voltage that is restricted to the limb leads is nonspecific and is likely of no clinical significance.

 

[macintoshblade]

The ST segments in V1 and V2 are not isolelectric and have a saddleback appearance. This is suggestive if Brugada type 3 pattern, which can be induced by cocaine. Low voltage that is restricted to the limb leads is nonspecific and is likely of no clinical significance.

Hallucinate harder.


To the post author:
there is nothing wrong with your 'very interesting' EKG, boy.