View source for Wide QRS Complexes in the Setting of Acute Myocardial Infarction: Good News or Bad?

{{NHJ|
|mainauthor= '''N.J.W. Verouden, R.J. de Winter, A.A.M. Wilde'''
|edition= 2009:01,062
}}
[[Image:Puzzle_2008_04_014_fig1a.png|Figure 1A|thumb]]
[[Image:Puzzle_2008_04_014_fig1b.png|Figure 1B|thumb]]

A 57-year-old man collapsed after one hour of
angina symptoms in the presence of the alarmed
ambulance personnel. He had never had any complaints
of chest pain before and his medical history did
not contain any cardiac events. Current smoking and
a positive family history were noted as risk factors for
coronary artery disease. Ventricular fibrillation (VF)
was recorded as the first rhythm and the patient was
successfully defibrillated with external DC shock. The
first ECG after defibrillation is shown in figure 1A,
followed by a second ECG (figure 1B) 40 minutes
later. 

'''What would be your diagnosis and thoughts?'''

[[Puzzle_2008_04_014_Answer|Answer]]