All ECG 145
- Normal sinus rhythm
- Prolonged QT interval
- T wave abnormality consistent with intracranial abnormality versus ischemia (Wellen's phenomenon)
This ECG must be interpreted according to the clinical context. If the patient came with a stroke, this could be a finding related to the neurologic injury. If acute chest pain were present, ischemia with a subtotal proximal left anterior descending coronary artery stenosis should be suspected (Wellen's phenomenon). It is less common for myocardial ischemia to prolong the QT inerval. This ECG was from an intracranial hemorrhage patient.
During an acute intracranial process such as intracranial hemorrhage or after carotid endarterectomy, dramatic ECG changes can be seen in the absence of any cardiac pathology. These include deep inversion of the T waves and prolongation of the QT interval. The connection between the brain and heart is poorly understood.
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