December 27, 2015

What is this wide rhythm?

A 75 yo h/o HTN, DM, dyslipidemia and non-ischemic caridomyopathy. What is your interpretation?

Figure 1

This is sinus tachycardia (~125 bpm), second degree AV block type 1 (Mobitz I/Wenckebach), left bubndle branch block (LBBB), left axis deviation, poor R wave progression.

Distinct P waves are marked in red arrows. Blue arrows marked the non-conducted P waves of the Wenckebach cycle. After the conducted beats, most of the P waves are hidden from view or are buried in the T waves or distorting the T wave morphology. The 5th to the last R wave could be a premature junctional beat. The nondconducted P wave is hidden or buried on that wave.

Figure 2


No comments:

Post a Comment

Note: Only a member of this blog may post a comment.