Syncope EKG

What to look for:

Mnemonic ABCDE-I:

Arrhythmia – heart block, PACs, PVCs
Brugada wave (Brugada syndrome)
C – prolonged qtc (Torsades)
Delta wave, short PR (WPW)
, Dagger Q waves (HOCM)
E – epsilon wave (arrythmogenic right ventricular myopathy)

(mnemonic kindly taught to me by Dr Jonathan "Snarky" Snider. Alternative mnemonics includes BLOW Hard by EM Basic


EKG: Normal Sinus Rhythm. No arrhythmia (no PACs, no PVCs), no heart block, no brugada wave, no prolonged QTc, no delta wave/no shortened PR, no dagger Q waves, no evidence of LVH, no epsilon wave, no evidence of ischemia.

EKG Interpretation: No arrhythmogenic etiology for syncope elucidated on EKG. Specifically, no evidence of arrhythmia, PAC, PVC, heart block, brugada syndrome, Torsades de Pointes, WPW, HOCM, arrhythmogenic right ventricular cardiomyopathy, ischemic. 

(With appreciation that ED evaluation and an EKG has limited sensitivity for arryhmogenic etiologies to syncope. As such, pt advised for prompt f/u with PMD to evaluation for Holter Monitor)



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