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Challenges in Clinical Electrocardiography |

ST-Segment Elevation Followed by Progressive Widening of the QRS Complex—Discussion

JAMA Intern Med. 2013;173(7):491-492. doi:10.1001/jamainternmed.2013.2959b.
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Published Online: March 11, 2013. doi:10.1001/jamainternmed.2013.2959a

Correspondence: Daniel Czuriga, MD, PhD, Institute of Cardiology, University of Debrecen, Medical and Health Science Center, Móricz Zs, krt 22, H-4032 Debrecen, Hungary (dczuriga@med.unideb.hu).

Conflict of Interest Disclosures: None reported.

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Figure 2. Fluoroscopic image of the patient's upper gastrointestinal tract. A vast number of oval objects can be observed in the stomach and the upper part of the duodenum.

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Figure 1. Initial 12-lead electrocardiogram recorded in the patient's home (A) and rhythm strip recordings of lead II during transportation (B) and shortly after arrival at the coronary care unit (C and D). Asterisks on panel A mark tented T waves with narrow bases. Note, that flattened P waves are discernable on panel B (arrows), but not on the following strips (C and D), which demonstrate progressive widening of the QRS complexes.

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Figure 3. Precordial leads of the initial electrocardiogram (magnified). Asterisks mark tented T waves with a narrow base. A coved ST-segment elevation can be observed in V1, and a saddle-back shape in V2.

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