u/IP686

Not my patient but my friend told me about this recent case. Good clinical case with good learning ECG.

4 yo, viral illness, fever, vomiting, skin almost grey, episodes of ALOC.

Two ECGs about 30 min apart.

Arrested once. Currently on ECMO.

Young male 31 yo, active chest pain, strong family hx, troponin 4900 --> 7700. Initially I thought ECG didn't show ischaemia, leaning towards myocarditis, given recent viral symptoms. Admitted under cardiology. TTE.showed hypokinetic/akinetic inferoseptal and basal inferior segments. I was surprised to find out he had not had coronary angiography 24 hrs after the initial presentation.

Any features on the ECG suggesting MI? Patterns of STEMI equivalent? I will follow up again and see what angio shows eventually.