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882 bytes removed ,  15:18, 11 November 2008
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{{Case|
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|previouspage= Case 2
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|previousname= Case 2
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|nextpage= Case 4
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|nextname= Case 4}}
 
[[Image:KJcasus9.jpg|thumb| The ECG]]
 
[[Image:KJcasus9.jpg|thumb| The ECG]]
* Following the 7+2 steps:
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**Rhythm
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***'''The ECG shows a regular rhythm with normal P waves (positive in I, III and AVF, negative in AVR), followed by QRS complexes. Sinusrhythm'''
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**Heart rate
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***'''78 bpm'''
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**Conduction (PQ,QRS,QT)
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***'''PQ: 180ms QRS: 160ms QT: 370ms QTc: 420ms
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**Heartaxis
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***'''Negative in III, AVF and AVR, positive QRS complexes in I, II and AVL: horizontal heart axis'''
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**P wave morphology
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***'''The P waves have normal morphology.'''
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**QRS morphology
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***'''Wide QRS complexes with [[[LBBB|left bundle branch block]]] pattern.'''
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**ST morphology
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***'''ST elevation in V1-V3, AVR. ST depression in I, II, III, AVF, V4-6. The Sgarbossa criteria for ischemia in LBBB are not met (nog concordant ST deviation, no ST depression V1-V3, nog discordant ST elevation > 5 mm).'''
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**Compare with the old ECG (not available, so skip this step)
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**Conclusion?
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'''Sinusrhythm with left bundle branch block, comparison with an old ECG is mandatory to evaluate whether the LBBB is new (a sign of [[myocardial infarction]]) or old.'''
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{{clr}}
 
{{clr}}
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Try to interprete this ECG using the 7+2 step method
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[[Answer Case 3|Answer]]

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