A 67-year-old man presents with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery bypass grafting (CABG). His left ventricular ejection fraction is 25% and an ICD is implanted after an episode of ventricular tachycardia. His ECG is shown (Figure 1).
Figure 1
The ECG demonstrates which of the following?
Show Answer
The correct answer is: E. C and D.
The ECG shows regular atrial paced rhythm with prolonged PR interval. The QRS axis is normal (approximately 45 degrees). The QRS is prolonged with the terminal forces directed inferiorly and laterally.
While the T wave is inverted in lead II, III and aVF. There is not sufficient Q wave in aVF to diagnose inferior infarction; however, the QRS delay represents inferior and lateral infarction block. The patient demonstrates dense fixed inferior and lateral defects.
References
Corne RA, Parkin TW, Brandenburg RO, Brown AL. Peri-infarction block: Postmyocardial-infarction intraventricular conduction disturbance. Am Heart J 1965;69(2).
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