Can't miss ECGs in syncope (quiz)

I overheard our main man Dave Grundy doing some bedside teaching about the four critical ECGs in syncope and I thought I would pass it on.

Most syncope in young (<45y/o) healthy patients only need a detailed account of the event (focus on preceding symptoms), a medical history (previous episodes, cardiac, seizures, trauma, ingestions, meds, diet), family history (sudden death), a focused neuro/cardiac exam, and consider a pregnancy and a bedside glucose test. Occasionally (rarely) you might want to check haemoglobin/electrolytes.

An ECG is basically mandatory on all syncope patients. Here are 4 ECGs to watch out for. Can you interpret them?   CLICK HERE for Answers

A) 36 year old woman has had intermittent episodes of lightneadedness 

B) 30 year old woman presents after syncopal episode 

C) 39 year old woman with muscle cramps and parasthesias 

D) 30 year old man with exertional palpitations and lightheadedness 

ECGs scanned from ECG for the Emergency Physician by Amal Mattu and William Brady