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A 55 year old man with 4 hours of "crushing" chest pain. Right Bundle Branch Block wide QRS, more than 120 ms (3 small squares) secondary R wave in lead V1 other features include slurred S wave in lateral leads and T wave changes in the septal leads See also Left Bundle Branch Block. Acute inferior MI and sinus bradycardia are also present. with permision from the site of Dr. Dean Jenkins