Podcast 821: EKGs in Syncope

<p><strong>Contributor: Travis Barlock, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">An EKG should be obtained quickly after a syncopal event to identify possible life-threatening causes such as ischemia and arrhythmia</span></li> <li style="font-weight: 400;" aria-level="1"> <strong>WOBBLER</strong> <span style="font-weight: 400;">is a good mnemonic for remembering additional EKG findings to look for in syncope</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;"> </span><strong>W</strong><span style= "font-weight: 400;">olff-Parkinson-White (WPW)</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Check for delta wave on QRS</span></li> </ul> <li style="font-weight: 400;" aria-level="2"> <strong>O</strong><span style="font-weight: 400;">bstructed AV node</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Any potential heart blocks</span></li> </ul> <li style="font-weight: 400;" aria-level="2"> <strong>B</strong><span style="font-weight: 400;">rugada syndrome</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Na channel blockade that can cause ST elevations in anterior leads</span></li> </ul> <li style="font-weight: 400;" aria-level="2"> <strong>B</strong><span style="font-weight: 400;">ifascicular block</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Conduction blockade in two of the three fascicles increases risk of complete heart block</span></li> </ul> <li style="font-weight: 400;" aria-level="2"> <strong>L</strong><span style="font-weight: 400;">eft Ventricular Hypertrophy (LVH)</span></li> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">Can be a sign of HOCM (younger patients) or aortic stenosis (older patients)</span></li> </ul> <li style="font-weight: 400;"