Complete Heart Block: Anterior MI

Report:

Sinus tachycardia

Third degree AV block

Ventricular escape beats and rhythm

Comment:

The slowing of the sinus rate in the forth and fifth strips was ominous, reflecting sinus node hypoxia or ischæmia.

The ventricular escapes were slow and unreliable.

Pacing was established (below), ensuring the patient died (later that day) in cardiogenic shock rather than asystole. In bad old days, patients used to be taken to the X-Ray department for pacemaker insertion; now mobile image intensifiers or, better still, balloon-guided pacemakers are used. The cost-effectiveness of this (like so much else) has never been established.

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