Alternating Left Anterior Hemiblock

Report:

Sinus tachycardia 102/min

Alternating LAD, probably LAHB

Acute or recent anterior infarction

Comment:

The presenting symptoms of both angina and infarction are often atypical in women5. This patient had post-infarction angina at the time of this recording.

A day earlier, all her complexes had LAHB morphology (Fig 8a below). In this trace the small initial q in lead 1 is more easily seen; it provides a point in favour of LAHB and against – but not absolutely – incomplete LBBB. On admission (Fig 8b) the intraventricular conduction was normal.

She did well following primary angioplasty.

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