STAT ECG Diagnoses: review of the causes of T wave inversions and detailed explanation of Wellens syndrome

ECG Weekly Workout with Dr. Amal Mattu


A young African American male who appears to be in his mid-20s is brought into the ED for decreased level of consciousness. There is some concern by EMS for suspected substance abuse. Exam and arrival vitals are non-diagnostic and reassuring. The following ECG is obtained with no priors available for comparison:

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

  1. What is your differential diagnosis for the T wave abnormality seen?
  2. What is your differential diagnosis for the ST segment elevation seen?
  3. Would you activate the cath lab?