Cardiac arrest after this ECG: what is the most likely cause?

ECG Weekly Workout with Dr. Amal Mattu


HPI

A 60-year-old man presents to the ED with midsternal chest pain that has been intermittent throughout the day. He collapses on arrival and suffers a cardiac arrest from which he could not be successfully resuscitated. His family states that he was discharged earlier today from another emergency department and told to follow up his PCP and return with worsening symptoms. The following ECG was obtained from his initial visit and documented as normal:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is your differential diagnosis
  3. What do you think was the cause of his cardiac arrest?