Differential Diagnoses: a triad of long QT interval, PVC’s, & ST segment depression

ECG Weekly Workout with Dr. Amal Mattu


A 56-year-old woman presents to a busy ED dehydrated with acute gastroenteritis. She is placed in a hallway bed and treated with IV fluids and ondansetron. On reassessment the patient is found unresponsive and in v fib arrest. She is defibrillated and the following post resuscitation ECG is obtained:

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

  1. What ECG abnormalities do you notice?
  2. What is the most likely cause of her cardiac arrest?
  3. What is the most likely diagnosis and next best step in management?