STAT ECG Diagnoses: a pediatric patient with syncope and an abnormal ECG

ECG Weekly Workout with Dr. Amal Mattu


A 9-year-old boy with PMHx of asthma presents to the ED with multiple pre-syncopal episodes. He has been evaluated for similar symptoms in the past by multiple physicians who suspected asthma as the likely cause. Vital signs and physical exam are normal, and he is asymptomatic on arrival. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What do you look for on the post-syncope ECG when the history and physical exam are non-diagnostic?
  3. What is the most likely diagnosis based on this ECG and next best diagnostic test?