A 32-year-old male presented to the emergency de-partment at midnight on a Sunday because of acuteonset of chest pain. He had carried a piano from oneroom to another earlier that day. The onset of the chestpain was a few hours later and not related to move-ment. The patient reported having undergone a heartcatheterisation at a different institution about 3months ago. The report of this procedure was unavail-able at the time of presentation, and the patient did notrecall the exact results. The past medical history wasremarkable for hypertension. His current medical ther-apy consisted of acetylsalicylic acid 100 mg daily. Phys-ical examination was unremarkable, the blood pressurewas 117/78 mm Hg, the heart rate was 68 bpm. His 12-lead ECG is shown in figure 1. Troponin T was withinnormal limits. Based on the clinical presentation, the
THE INTERESTING ECG
A bad memory
Michael Kühne, Stefan Osswald
Cardiology, University Hospital, Basel
Kardiovaskuläre Medizin 2009;12(3):94–95
Correspondence:Michael KühneCardiologyUniversity Hospital BaselPetersgraben 4CH-4031 Baselkuehnem@uhbs.chThere is no conflictof interest.
12-lead ECG at the time of presentation with T-wave changes in the inferior leads.
12-lead ECG on the day after radiofrequency catheter ablation of a posteroseptal accessory pathway with deeply inverted T-waves in the inferior leads and tallT-waves in V
reflecting the axis of the delta wave during preexcitation.