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Older woman with chest pain
  1. Rahini Kannan,
  2. Gunaseelan Rajendran,
  3. Sasikumar Mahalingam
  1. Emergency Medicine, Aarupadai Veedu Medical College & Hospital, Vinayaka Missions Research Foundation (DU), Kirumampakkam, Puducherry, India
  1. Correspondence to Dr Sasikumar Mahalingam; sasiempub{at}gmail.com

https://doi.org/10.1136/emermed-2024-213983

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    Clinical introduction

    A woman in her 60s with a history of hypertension and diabetes arrived at the emergency department reporting chest pain persisting for the past 4 hours. Describing it as retrosternal and crushing, she noted radiation to her right arm, accompanied by sweating and palpitations. She had a resting pulse of 70 bpm and blood pressure of 130/80 mm Hg. Cardiovascular examination yielded normal findings. A 12-lead ECG was promptly obtained (figure 1).

    Figure 1

    12-lead ECG of the patient.

    Question

    What is the most likely diagnosis?

    A. De Winter’s T wave.

    B. Wellens syndrome.

    C. Aslanger pattern.

    D. Brugada pattern.

    Answer—C. Aslanger pattern

    Aslanger pattern is an ST-elevation myocardial infarction (STEMI) equivalent, specific for an inferior myocardial infarction. It is often …

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    Footnotes

    • Handling editor Sarah Edwards

    • X @drrigs08, @sasiempub

    • Contributors RK: Conceptualisation, Resources, Writing—original draft. GR: Conceptualisation, Resources, Writing, Reviewing and Editing. SM: Conceptualisation, Resources, Writing, Reviewing and Editing, Visualisation. SM: Takes full responsibility for the article as a whole and acts as a guarantor, accepts full responsibility for the work and the conduct of the study, has access to the data and controlled the decision to publish.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.