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: Ivan Rios Tags: 12 lead ecg pediatrics pulmonary hypertension Source Type: research
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