EKG of the Month

Things aren’t always what they seem at times as our patients like to throw the proverbial knickle ball.  It just kind of hangs there, then goes in a completly different direction, baffling both you and the batter.  While there are very few knucklers left in the Majors, it seems that they come in droves in medicine.  There almost always is a strange case that grabs your attention and makes you think.  All the signs point in one way, but the reality is far different.  Such is the case here.

First, a brief  synopsis.

Deborah Peel, a 28 year-old, 6-month post-partum patient arrives at the ED complaining of weakness.  This EKG is grabbed on admit.

To give much more information (including what kind of weakness it was) would give this away.  Suffice to say, labs were normal, including cardiac enzymes.  Vitals signs were stable, blood pressure was slightly elevated though.  Patient was complaining of no chest pain or other symptoms that would be expected with the tracing shown above.  No previous history, normal delivery without complications 6 months prior.  The other clue I will lay out is that the patient went for a CT, followed by another imaging modality before arriving on my floor.

Any guesses?  C’mon, fame and glory await!  Leave your guesses in the comments.

P.S.  I have to work the next couple of days,but I’ll be checking to see and will confirm or deny guesses,also in the comments.  I will also say that my firend who looked at this said, “Did you call the doc? How about an EKG when they got to the floor?”  Both of which were answered in the negative.  Is your brain in gear?

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5 Comments

  1. Nope. Shows NSR on 5 lead telemetry monitoring. The weakness is localized – possibly one sided…

    I can’t give too much as it becomes pretty simple. The differential is really wide, but the clues may be there. I will say that the imaging done was above the xyphoid process (about 18″+).

    Reply

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