A woman in her 50s with a history of hypertension and alcohol abuse presented to the emergency department with 4 episodes of syncope in the preceding 24 hours. She denied prodromal symptoms of chest pain, dyspnea, palpitations or presyncope. Her medications included perindopril, metoprolol, and a magnesium supplement. On examination, her blood pressure was 121/79mmHg, heart rate was 65 bpm, and her respiratory rate was 24 breaths/min. She was afebrile and had normal oxygen saturations on room air.
A 12-lead electrocardiogram (ECG) was obtained (image 1). Based on the case presented, what is the likely etiology of her syncope? What should you do next? ECG Interpretation The ECG revealed sinus rhythm at approximately 60 bpm, with diffuse nonspecific ST-segment changes, giant U waves, and slurring of the T waves into the U waves . It is challenging to assess the precise corrected QT(U)…
