History:
This ECG was recorded from a 86 year-old man while he is having palpitations. He had a Right sided CVA 5 days ago. On examination he has a diastolic murmur maximumally at the left sternal edge.
ECG shows:
2 Rhythms are present:
-beats 1-2 end of junctional tachycardia, 125/min
-retrograde p wave seen following the QRS in III (inverted)
-beats 3-13 Sinus Rhythm, 82/min, with left axis deviation
Features of left atrial abnormalties:
-Board (more than 3 small squares), notched p waves in inferior leads
First degree heart block (PR interval, 0.28 sec)
Ventricular premature beat (last beat on rhythm strip)
Features of incomplete LBBB
-QRS 119ms
-loss of septal q waves in lead V5-6, I and aVL
Features of systemic hypertension
-Left ventricular hypertrophy
-non specific lateral ST changes (ST depression in V4-6)
Back to case 2
