McGill Case 331

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 330 | Next Case: McGill Case 332

This is an electrocardiogram from a 77 year old man with a history of coronary artery disease. He was taking Monopril, metoprolol, ASA and Hytrin. The cardiogram shows sinus rhythm with a marked first degree heart block ( about 360ms). There is also a poor R wave progression across the precordial leads and a Q wave in V2 suggestive of a previous anterior wall infarction. The QRS also has a left axis deviation best described as a left anterior hemi-block.