Robbie

And let me summarize what those changes are.

He definitely has T-wave inversions in V2 through V3.

But he also has a little bit of depression in V1.

Awesome, Proferes.

So Proferes is being nice enough to zoom in on it for me.

Perfect.

So this is definitely a change in his prior... So automatically, I'll just show you what I'm thinking.

I'm thinking... Do you mind keeping that up for just a little longer?

Yeah.

I'm thinking, okay, this is a Wellens, and I'll talk through my differential diagnosis for Wellens.

So for me, I immediately look at this, and I'm like, oh my gosh, this is a Wellensoid pattern, because he has...

T-wave inversions in V2 and V3.

But what I'm going to do is share a quick differential diagnosis for this EKG.

And there are essentially three things that can do this.

The most important is that a patient has acute coronary syndrome.

And this EKG is as a result of spontaneous thrombolysis.

The other possibility is that this patient has a pulmonary embolism, and the clues to the presence of a pulmonary embolism are a Wellens-like pattern, but with associated similar changes in the inferior leads, which unfortunately for him, he has.

So he has a T-wave inversions in lead III and lead AVF, which have me a little bit worried about that possibility of P.E.,

The third differential diagnosis that causes is Takotsubo's.

And there are some other changes in AVR that are at place.