Differential Diagnosis for Sinus Rhythm with Borderline Short PR Interval and RSR' in V1 or V2
- Single most likely diagnosis:
- Normal variant: This is the most likely diagnosis given the description of the ECG findings as "probably normal variant" and the presence of a borderline short PR interval with RSR' in V1 or V2, which can be seen in healthy individuals.
- Other Likely diagnoses:
- Wolff-Parkinson-White (WPW) syndrome: Although less likely, WPW syndrome should be considered due to the short PR interval, which could indicate an accessory electrical pathway in the heart.
- Hypokalemia: Minimal ST depression can be seen in hypokalemia, and while not directly related to the RSR' pattern, it's a condition that can cause various ECG abnormalities.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Acute coronary syndrome (ACS): Although the ST depression is described as minimal and diffuse, ACS must be considered, especially if the patient presents with chest pain or other symptoms suggestive of cardiac ischemia.
- Cardiac sarcoidosis: This condition can cause various ECG abnormalities, including those described, and is important to consider due to its potential for serious cardiac complications.
- Rare diagnoses:
- Lown-Ganong-Levine (LGL) syndrome: A rare condition characterized by a short PR interval, which could fit the described ECG findings, but is less common than WPW syndrome.
- Arrhythmogenic right ventricular cardiomyopathy (ARVC): The RSR' pattern in V1 or V2 could suggest right ventricular involvement, but this diagnosis would typically require additional clinical and imaging findings to support it.