McGill Case 355

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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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This is a regularly irregular rhythm. The PR interval is about 200 ms, and the QRS duration of the narrow beats is about 80 ms. There are Q waves in the inferior leads and there is T wave inversion in leads I, aVL, V4 to V6. The wide complex beats have a duration of 130 ms and have a LBBB configuration. Note the bump in the beginning of the ST segment in leads V1, V2 and II suggestive of a P wave buried in this area. Note also the compensatory pause after the wide beats. This is a recording of sinus rhythm with ventricular premature beats in trigemini. The inferior Q waves suggest an inferior MI.