McGill Case 330

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 329 | Next Case: McGill Case 331

This is an electrocardiogram, a 64 year-old man with a history of coronary artery disease. The patient was taking amiodarone , metoprolol , and Vasotec at the time of this recording. This was a routine recording. The electrocardiogram shows sinus rhythm with a prolonged P wave > 120 milliseconds. The P wave is notched in the inferior leads. This is consistent with a left atrial abnormality. The PR interval is long at 200 milliseconds and is diagnostic of first-degree heart block. The Q waves in the Interior leads suggest an inferior wall infarction .