Which ECG changes are associated with coronary thrombosis during pulseless electrical activity in a child?

Which ECG changes are associated with coronary thrombosis during pulseless electrical activity in a child?

• A. ST-segment changes, T-wave inversions, and/or Q waves
• B. Only ST-segment elevation
• C. Delta waves
• D. Low-voltage QRS

Answer: (A)

Coronary thrombosis during pulseless electrical activity can cause myocardial ischemia and evolving infarction, so the ECG often shows a range of injury patterns rather than one fixed change. ST-segment deviations reflect acute injury to the heart muscle, T-wave inversions indicate repolarization abnormalities after ischemia, and Q waves can develop with necrosis indicating infarcted tissue. Together, these changes capture the spectrum of ischemic ECG manifestations that can occur in this scenario, making them the best fit. Delta waves would point to pre-excitation and are not related to thrombosis-induced ischemia, and low-voltage QRS is non-specific and less indicative of acute coronary events in this setting.

Coronary thrombosis during pulseless electrical activity can cause myocardial ischemia and evolving infarction, so the ECG often shows a range of injury patterns rather than one fixed change. ST-segment deviations reflect acute injury to the heart muscle, T-wave inversions indicate repolarization abnormalities after ischemia, and Q waves can develop with necrosis indicating infarcted tissue. Together, these changes capture the spectrum of ischemic ECG manifestations that can occur in this scenario, making them the best fit. Delta waves would point to pre-excitation and are not related to thrombosis-induced ischemia, and low-voltage QRS is non-specific and less indicative of acute coronary events in this setting.