دانشجویان پزشکی 87 کرمان
This ECG shows:
The appearances here are suggestive of an anterior non-Q wave myocardial infarction, but this does not correspond with the clinical picture.
What to do
It is possible that this patient had a myocardial infarction which caused a cerebrovascular accident because of an arrhythmia, or because of a cerebral embolus, and that the cerebrovascular accident caused the seizure. The unconsciousness and the bilateral extensor plantar responses could simply be post-ictal. However, such a sequence would not explain the stiff neck, which would seem to point to either a subarachnoid haemorrhage or meningitis. Changes like those on this ECG are common in subarachnoid haemorrhage, probably because of intense coronary vasospasm resulting from catecholamine release. Measurements of the blood troponin level are unlikely to help differentiate between a primarily cardiac and a primarily neurological event. This patient did indeed have a subarachnoid haemorrhage, and the ECG eventually returned to normal.
Anterior and inferior T wave inversion due to
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