Course: Giant T-wave Inversion in an Older Patient With Sudden Loss of Consciousness
CME Credits: 1.00
Released: 2023-03-20
A patient in their 60s with a history of long-term uncontrolled hypertension presented to the emergency department reporting left hip pain and reduced mobility owing to a fall 2 days prior. A hip fracture was suspected, and external fixation and skin traction were performed after admission to the orthopedics department. In the early morning of day 2 after admission, the patient suddenly lost consciousness. A 12-lead electrocardiogram (ECG) was immediately performed; its findings are shown in , A. For comparison, the findings of an ECG performed before admission are shown in , B. The patient’s high-sensitivity cardiac troponin-I serum level was 0.21 µg/L (reference, <0.023 µg/L). Findings of a neurologic examination showed bilateral pupil size, 2.5 mm; right limbs, unresponsive to pain stimuli and with hypotonia; all limbs, reduced tendon reflex; and bilateral Babinski reflex, negative. Acute myocardial infarction was suspected, and a cardiologist was consulted.
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