Tall T Waves: Myocardial Rupture

Report:

Sinus rhythm

Third degree AV block

Junctional escape rhythm 43/min

Prominent T waves

Comment:

A rare cause of tall T waves, not unlikely in this case, is free wall rupture167. Other causes (infarction, reciprocal change to remote infarction, hyperkalæmia) cannot be excluded; however, sudden EMD remains, to use D. H. Spodick’s tongue-in-cheek term, ‘suggestoid’ of rupture. He actually refers to tall T waves in hæmopericardium of any ætiology, ascribing it to hæmolysis and local hyperkalæmia168.

The relatively short QT interval may reflect iatrogenous hypercalcæmia provoked by the EMD169.

238. Terminal strips of a 71 year old man in multiple organ failure

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