Mime of Cerebral Injury
Report:
Sinus rhythm 75/min
Borderline low voltage
Poor R wave progression
Diffuse T wave inversion
Prolonged QT interval
Comment:
The tracing is quite suggestive of a cerebral event, but there was none. Cardiac catheter showed segmental akinesia and hypokinesia with normal coronary arteries. In this setting, pheochromocytoma is a possibility (but I lost track of the patient when she left ICU). It is, after all, a catecholamine surge that gives rise to myocardial injury in CVAs. Another is myocarditis, except I have never seen one like this, with broad inverted T waves and long QTc.
Four days later, in CCU, she had a very similar trace (Fig 49a).
49a. 50. Anxious 24 year old man in Casualty with vague symptoms
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