Inferior Infarction and Left Anterior Hemiblock

Report:

Sinus rhythm 78/min

Left axis deviation – 72o

Left anterior hemiblock

Old inferior infarction

Clockwise rotation (late transition)

Comment:

The LAHB is seen as inferior QS waves > 5 mm in depth, lack of secondary R waves in the inferior leads and their presence in aVR and RS morphology of V6. In fact, the inferior leads do not have simple QS morphology: it is qrS in lead 2, there is a descending “ledge” in lead 3 and a sharp notch in the QS descent in aVF: imprint of LAHB on the inferior MI.

No Q wave in lead 1 is a sign of inferior infarction (less secure here, with small R wave), as is of course the lack of primary R waves in the inferior leads.

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