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ECG OF THE WEEK Prof.Dr . G.ELANGOVANâ€™S unit Dr.M.Amudhan
73 year old male presented with c/o giddiness on & off for past 1yr. chest pain past 2 days Past history; not a k/c/o T2DM/SHT/IHD No other significant history O/E pt concious ,oriented, afebrile. no pallor/icterus/cyanosis/clubbing/LN/pedal edema Vitals; PR 84/min BP 150/90 Cvs: s1 s2 heard. No murmurs. RS: nvbs heard, no added sounds, Other systems also normal.
In this ECG Rate â€“ 80/min Rhythm â€“ sinus rhythm P wave morphology â€“ normal PR interval â€“ 0.24 s QRS duration â€“ 0.16 s, QRS axis: - 40 degrees QRS morph. â€“ RRâ€™(M pattern) in V5,V6,aVL & L1 with secondary ST-T Changes Deep S waves in V1-V3 & L2 & L3 ST eievation in V1 â€“ V3
ECG LBBB + First degree AV block POSSIBLE TRIFASCICULAR BLOCK WHICH HAS TO BE CONFIRMED ONLY BY HIS BUNDLE ELECTROGRAM
INTRA â€“ VENTRICULAR CONDUCTION DEFECTS
Abnormality in conduction thru one or more divisions of intra ventricular conduction system distal to Bundle of His
Various conduction defects include:-
RBBB LBBB LAFB LPFB Parietal Block Peri Infarction Block