The role of 12 lead ECG in Pediatric Pulmonary Hypertension

A 10 year old male presents to the Emergency Department with complaint of substernal chest pain, 6/10, unable to describe the sensation but non-radiating, which started during a basketball game, while running. Primary assessment: Patent airway Adequate respiratory effort with no signs of distress skin is pink, warm and dry, with no signs of hypoperfusion Pertinent medical Hx: Chronic Interstitial Lung Diseases secondary to Human T-cell Lymphotropic Virus (HTLV) Secondary Pulmonary Hypertension No allergies reported Medications: Acetaminophen PRN furosemide  20mg Flovent Baseline vital signs: Heart rate: 112 beats/min Respiratory rate: 24 breaths/min SpO2: 97% on 2 lpm O2 Capillary refill: < 2 seconds The patient is evaluated and admitted due to the current complaint and prior medical complications. The following 12 lead ECG is obtained:   Sinus rhythm Biatrial Enlargement or Abnormality Right Ventricular Hypertrophy (R > 7mm in V1-2) Rightward Frontal Axis (QRS axis approximately 121 degrees) Right Precordial ST segment depression As many prehospital and in-hospital providers are initially taught, ST segment depression and T wave inversion indicates myocardial ischemia. However, there are other conditions which can present with ST segment depression and T wave inversion, and not be ischemia related. These are commonly due to ventricular repolarization abnormalities, electrolyte imbalances such as Hypokalemia (low serum Potassium) and Hypomagnese...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 lead ecg pediatrics pulmonary hypertension Source Type: research