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Published in: Netherlands Heart Journal 3/2017

Open Access 01-03-2017 | Rhythm Puzzle - Question

Typical ECG findings in an unconscious patient

Authors: R. Joustra, F. N. Polderman, J. L. Smeets, M. C. Daniëls, M. Boulaksil

Published in: Netherlands Heart Journal | Issue 3/2017

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Excerpt

A 62-year-old woman known with a depressive disorder but unremarkable cardiovascular history was admitted to our emergency department in a state of unconsciousness. Her husband had found her unconscious at home and called an ambulance. She had no history of syncope or suicidality. Physical examination demonstrated a Glasgow Coma Scale of E1M5V1 without any lateralising neurological symptoms. She was haemodynamically stable, but was intubated because of failure to maintain airway tone due to unconsciousness. She had no fever. Laboratory results showed: sodium 150 mmol/l, potassium 3.2 mmol/l, a normal glomerular filtration rate, haemoglobin 7.6 mmol/l; normal thrombocytes and leucocytes. The ECG on admission is shown in Fig. 1.
1.
What is your diagnosis?
 
2.
What is the most likely mechanism?
 
Metadata
Title
Typical ECG findings in an unconscious patient
Authors
R. Joustra
F. N. Polderman
J. L. Smeets
M. C. Daniëls
M. Boulaksil
Publication date
01-03-2017
Publisher
Bohn Stafleu van Loghum
Published in
Netherlands Heart Journal / Issue 3/2017
Print ISSN: 1568-5888
Electronic ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-016-0909-4

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