Pseudo infarction
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The document discusses conditions that can mimic myocardial infarction through changes in ECG readings, including WPW preexcitation, IHSS, LVH, and others. A case vignette illustrates a 62-year-old woman with a unique ECG pattern indicative of Wolff-Parkinson-White syndrome. The document emphasizes the importance of accurate ECG interpretation to differentiate these conditions.
Pseudo infarction
- 2. ECG CONDITIONS THAT MIMIC MYOCARDIAL INFARCTION EITHER BY SIMULATING PATHOLOGIC Q OR QS WAVES OR MIMICKING THE TYPICAL ST-T CHANGES OF ACUTE MI • WPW preexcitation (negative delta wave may mimic pathologic Q waves) • IHSS (septal hypertrophy may make normal septal Q waves "fatter" thereby mimicking pathologic Q waves) • LVH (may have QS pattern or poor R wave progression in leads V1-3) • RVH (tall R waves in V1 or V2 may mimic true posterior MI) • Complete or incomplete LBBB (QS waves or poor R wave progression in leads V1-3) • Pneumothorax (loss of right precordial R waves) • Pulmonary emphysema and cor pulmonale (loss of R waves V1-3 and/or inferior Q waves with right axis deviation) • Left anterior fascicular block (may see small q-waves in anterior chest leads) • Acute pericarditis (the ST segment elevation may mimic acute transmural injury) • Central nervous system disease (may mimic non-Q wave MI by causing diffuse ST-T wave changes)
- 3. CASE VIGNETTE • A 62yrs woman presented with frequent episodes of palpitation for last 7-10yrs • Palpitation was more marked during bathing • No other comorbidities • ECG :RIGHT FREE WALL PATHWAY • ECHO study was normal
- 5. RIGHT LATERAL PATHWAY:THE WOLFF- PARKINSON-WHITE SYNDROME • Negative delta and negative QRS in V1 • QS in inferior leads • Discordant T in the inferior leads: T is upright when there is QS in these leads • Left axis deviation
- 6. IT IS NOT TOO LATE TO LEARN AT ANY AGE