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Challenges in Clinical Electrocardiography
July 31, 2023
HuiShu,MD1; Bao-jianLiao,PhD2; DingPeng,MD2
Author Affiliations Article Information
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1Xi'an Central Hospital, Xi'an, Shaanxi, China
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2The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Guangdong, China
JAMA Intern Med. 2023;183(9):1013-1014. doi:10.1001/jamainternmed.2023.1743
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A patient in their 50s went to the emergency department for treatment due to intermittent compression-like pain in the chest of 1 day’s duration that lasted for several minutes each time. It occurred during activities and could be relieved after rest. The patient had a history of hypertension and diabetes for 8 years and was not regularly taking medication. When arriving at the emergency department, the patient's chest pain was relieved. Physical examination showed that their blood pressure was 181/93 mm Hg, heart rate was 81 beats per minute, respiration was 20 times per minute, and blood oxygen in indoor air was 96%; the rest of the examination yielded normal results. The patient’s 12-lead electrocardiogram (ECG) was consulted (Figure, A). About 10 minutes later, the patient's chest pain recurred, and the 12-lead ECG was repeated (Figure, B). Initial laboratory workup findings were largely unremarkable, with creatinine and high-sensitivity troponin levels all within normal limits. Serum electrolyte levels, including K+ and Ca2+, were grossly normal.
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Cardiology Emergency Medicine Challenges in Clinical Electrocardiography Acute Coronary Syndromes Ischemic Heart Disease
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Shu H, Liao B, Peng D. Inverted U Waves—Red Flags in Electrocardiograms. JAMA Intern Med. 2023;183(9):1013–1014. doi:10.1001/jamainternmed.2023.1743
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