This ECG is from a 68 yr male who presented with 24 hours of dysponea and palpitations.No past medical history of note and he takes no regular medications.
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Things to think about
- What are the key ECG features ?
- What are the potential reversible causes for these features ?
- How would you manage this patient ?
- Ventricular rate 42 bpm
- Atrial rate 84 bpm
- Regular atrial and ventricular activity
- 2:1 AV block
- PR – Normal (~200ms)
- QRS – Prolonged (140ms)
- RBBB Morphology
- Prominent T wave lead III in relation to QRS height
What happened ?
The patient was admitted under the cardiology team and telemetry revealed intermittent variable AV block (2nd and 3rd degree) and he underwent an uneventful dual chamber PPM insertion.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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