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Higher risk of myocardialinfarction, heart failure and atrialfibrillation was noted in spinal cord injury survivors compared to controls. Increased Risk of MyocardialInfarction, Heart Failure, and AtrialFibrillation After Spinal Cord Injury. Am J Phys Med Rehabil. 2007 Feb;86(2):142-52.
Echocardiographic assessment of left ventricular diastolic function with special reference on diastolic function assessment in atrialfibrillation. In atrialfibrillation, the absence of atrial contraction and the A wave makes this assessment impossible. J Cardiovasc Ultrasound. 2011 Dec;19(4):169-73.
Left ventricular hypertrophy, left atrial enlargement, QRS axis deviation (left more than right), conduction abnormalities like increased P-R interval and bundle branch block may be noted. Thin posterior wall in inferior wall myocardialinfarction causing abnormal septal to posterior wall ratio can also cause suspicion of ASH.
The authors reported that the regular use of fish oil supplements might be a risk factor for atrialfibrillation among general population. In their study healthy stage was considered as primary stage, occurrence of atrialfibrillation as secondary stage, major adverse cardiovascular events tertiary stage and death as end stage.
So this is a typical Brugada syndrome ECG, which can be easily mistaken for an acute myocardialinfarction with ST elevation in anterior leads may be taken as STEMI if the person presents with chest pain for some other reason. Of course, the commonest sustained arrhythmia in general population is atrialfibrillation.
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