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.


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The rhythm is sinus, and the QRS is wide (>120ms.) There is a dominant R in I and V6 with the loss of septal q waves in I and the lateral precordial leads. There is a q in lead aVL but over all the recording suggests a left bundle branch block.