Publish in this journal
Journal Information
Vol. 73. Issue 3.
Pages 259 (March 2020)
ECG Contest
DOI: 10.1016/j.rec.2019.10.019
Full text access
Response to ECG, February 2020
Respuesta al ECG de febrero de 2020
Pablo Martínez-Vives
Corresponding author

Corresponding author:
, Luis Jesús Jiménez-Borreguero, Fernando Alfonso
Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
Related content
Rev Esp Cardiol. 2020;73:17110.1016/j.rec.2019.08.013
Pablo Martínez-Vives, Luis Jesús Jiménez-Borreguero, Fernando Alfonso
This item has received
(Daily data update)
Article information
Full Text
Download PDF
Figures (1)
Full Text

The electrocardiogram recorded during exercise testing shows a broadening of the final QRS complex over an underlying right bundle-branch block and left axis deviation (a left anterior hemiblock is present). This is indicative of inducible ischemia involving the anterior fascicle of the left bundle branch, and so response 4 is correct. Furthermore, after the performance of single-photon emission computed tomography with methoxy isobutyl isonitrile (SPECT-MIBI), reversible hypoperfusion is observed at the inferolateral wall, consistent with territory damaged by the known coronary artery disease (figure 1). Response 1 is incorrect because significant electrical abnormalities are present. Response 2 is incorrect because spiked T waves in the left precordial leads are a frequent finding in right bundle branch block, without necessarily indicating the presence of inducible ischemia. Response 3 is incorrect because, in presence of right bundle branch block, ST segment depression in the right precordial leads is frequent in the absence of inducible ischemia.

Figure 1
Copyright © 2019. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.