EKG of the Week
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+ EKG Interpretation
Dr. Ohlbaum's Explanation
Let's start by looking at the rhythm. Are there P waves? Yes, regular P waves at a rate ~90. The P waves are upright in inferior leads. So, this is sinus rhythm. Is every P followed by a QRS? No, some of the Ps are conducted and some are not. So, 2nd degree AV block. Is it Mobitz I or II? The PR is shorter after the "missing" QRS and gets progressively longer before the next dropped QRS so this is Mobitz I.
The rhythm is sinus rhythm with 2nd degree AV block in a Mobitz I pattern.
The P wave is big and does not look normal. It is notched in the inferior leads but the negative part in Vl not big enough to be convinced about LAE (though I will cheat and tell you that left atria big on echo).
His QRS is wide but does not quite fit for either right or left BBB (big Qs in I and AVL for example argue against LBBB) so I would call this a nonspecific intraventricular block.
