Syndromes

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    52 year old homeless male found unconscious.

    52 year old homeless male found unconscious.

    Key Findings

    - Sinus rhythm with premature atrial complexes

    - Diffuse and symmetric T-wave inversion

    - Prolonged QT interval

    Coding for the Boards

    - Sinus rhythm

    - Atrial premature complex

    - Left axis deviation

    - ST abnormality suggesting myocardial ischemia

    - Prolonged QT interval

    - Central nervous system disorder

    Answers

    Discussion: The pattern of T-wave conversion and the clinical scenario suggests subarachnoid hemorrhage.