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Right Bundle Branch Block with Old Inferior Wall Infarction
Interpretation by Matthew Schumaecker
EKG recorded by Dr. M. Rosengarten, MUHC, 1997
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Interpretation by Matthew Schumaecker
EKG recorded by Dr. M. Rosengarten, MUHC, 1997
The heart rate is 120/min and the QRS complex durations is 150 ms. There is a conspicuous lack of clearly seen P waves.
Ventricular tachycardia is possible with the QRS complex duration of 150 ms but is unlikely as the r in V1 is small, the R/S ratio in lead V6 is less than one and there is no sign of AV dissociation or of capture beats. The rhythm is probably a sinus tachycardia with first degree heart block (P waves falling on the T waves) or a junctional tachycardia.
Right bundle branch block is indicated by rSR' variant morphology in V1-V3 and wide, slurred S waves in I and V6. There is a left axis deviation. Inferior infarction is indicated by the qs complexes in III and aVF. It is probably old.
