How would you manage this patient? (Case 11-01)

What is your interpretation? 
Which test might be of help? 
How would you tell ? 

How would you manage this patient? 
 
The 12 lead  ECG shows an early Repolarization pattern

Notch on the S wave 
J point elevation of >1mm (0.1mV) on 2 consecutive leads 

This pattern was found with a higher incidence in pts who suffered a cardiac arrest related 
to idiopathic VF.

Management

The clinical work-up including  echocardiogram concluded  that the patient had a normal heart. There was no family history of sudden death. 
The patient underwent a head-up tilt test which was positive. The diagnostic of cardiogenic vaso-vagal syncope was likely. 
The patient was discharged. The diagnosis of ER pattern differs from that of the ER syndrome. We did not inform the patient to avoid unecessary anxiety1 and reassured him 

1. Levy and Sbragia. J of Interventional Electrophysiology 2011;32:181-6 

Your comments will be welcome!


 

Figure: 12 lead ECG

 


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