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(Circulation. 2006;113:e753-e756.)
© 2006 American Heart Association, Inc.

Clinician Update

Electrocardiogram

Still the Cardiologist’s Best Friend

Shlomo Stern, MD

From the Hebrew University of Jerusalem, Jerusalem, Israel.

Correspondence to Dr Shlomo Stern, FAHA, 1 Shmuel Hanagid St, Jerusalem 94592, Israel. E-mail sh_stern@netvision.net.il

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Case presentation: A 22-year-old male, previously healthy, came to the outpatient clinic soon after an episode that he described as "near fainting" during complete rest, but at the time he was feeling strong anger because of a dispute with his friends. The physical examination was normal, but the resting 12-lead ECG, taken for the first time in his life, showed alterations diagnosed as Brugada syndrome (Figure). Holter monitoring showed the typical signs of the syndrome with no other abnormalities. The patient was referred for further evaluation, including family search for this syndrome, which turned out negative. Currently, implantation of an implantable cardioverter-defibrillator is being considered in a tertiary hospital for this patient.

View larger version (18K): [in this window] [in a new window]   Twelve-lead ECG of the patient showing typical changes for Brugada syndrome.

	Background

 
In the last several years, we have seen a new surge of interest in electrocardiology.¹ In the following report, we describe innovations in interpreting the 12-lead ECG in the physician’s office that contribute to an instant diagnosis and to practical conclusions in our day-to-day clinical practice.

	Patients at High Risk for Sudden Cardiac Death

 
Although >90% of cases of sudden cardiac death (SCD) occurs in persons without known or previously recognized structural or functional cardiac abnormalities, scrutinizing the QRS voltage, as well as the QT and corrected QT (QTc) intervals of the surface ECG, will help in diagnosing risk factors for SCD. A QTc >450 ms for men and >470 ms for women was an independent risk factor for SCD in subjects enrolled in the Rotterdam Study aged 55 years; a 3-fold increased . . . [Full Text of this Article]

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