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Difficulty: MediumCardiovascular System

Match each clinical condition or syndrome with its classic electrocardiographic (ECG) finding.

  • Brugada syndromePseudo-right bundle branch block and coved ST-segment elevation in leads V1-V3
  • Wellens syndromeDeeply inverted or biphasic T waves in leads V2-V3 during a pain-free interval
  • Wolff-Parkinson-White patternShort PR interval, widened QRS complex, and a slurred initial QRS upstroke
  • Acute pericarditisWidespread concave ST-segment elevation and reciprocal PR-segment depression

Answer

Brugada syndrome matches with pseudo-right bundle branch block and coved ST elevation in V1-V3. Wellens syndrome matches with deeply inverted or biphasic T waves in V2-V3 during a pain-free interval. Wolff-Parkinson-White pattern matches with a short PR interval, widened QRS, and a slurred initial QRS upstroke. Acute pericarditis matches with widespread concave ST-segment elevation and reciprocal PR-segment depression.
Each syndrome has a highly distinct, pathognomonic ECG signature. Brugada syndrome involves sodium channel dysfunction leading to right precordial ST changes. Wellens syndrome reflects reperfusion of a critical LAD occlusion. WPW is caused by pre-excitation via the bundle of Kent. Acute pericarditis produces diffuse inflammatory electrical changes.

Step-by-Step Solution

1
Analyze the right precordial lead changes (V1-V3) associated with channelopathies.
Brugada syndrome matches with pseudo-right bundle branch block and coved ST elevation in V1-V3.
These are the hallmark Brugada type 1 ECG findings that predispose patients to sudden cardiac death.
2
Evaluate the anterior lead changes occurring during pain-free intervals in acute coronary syndromes.
Wellens syndrome matches with deeply inverted or biphasic T waves in V2-V3.
This specific pattern represents a highly specific marker for critical proximal left anterior descending artery stenosis.
3
Identify the ECG manifestations of an atrioventricular accessory pathway.
Wolff-Parkinson-White pattern matches with a short PR interval, widened QRS, and slurred initial QRS upstroke.
The accessory pathway (bundle of Kent) bypasses the AV node, causing early ventricular depolarization visible as a delta wave.
4
Determine the electrocardiographic hallmark of generalized epicardial inflammation.
Acute pericarditis matches with widespread concave ST-segment elevation and PR-segment depression.
Diffuse inflammation affects multiple coronary territories simultaneously, which is distinct from localized ischemia.

Key Concept

Recognition of classic high-yield electrocardiographic syndromes and their specific morphologic findings.
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Topics

Cardiovascular System

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