This patient presented with alcohol intoxication and possible overdose. No ischemic symptoms.

 

Rate 71

PR 224

QRSD 90

QT 424

QTc 461

 

There is ST depression in V4-V6 (minimal). She is in alcohol intoxicated: high risk for hypokalemia.

Differential of ST depression is:

Secondary to abnormal QRS (LVH, LBBB, RBBB, etc.)

Primary ischemia

Hypokalemia

Digoxin

Normal variant.

 

This patient had a K of 2.8. Difficult case because she does not have prominent U waves (though they are there) Source