All Journals from Balasubramaniam K
A 64-year-old male presents to the emergency department in acute respiratory distress. He gives a limited history of progressive shortness of breath of one week’s duration and several episodes of sudden unexplained syncope. There was no history of chest pain, palpitations or localising symptoms of infection. He takes no regular medications.
The initial ECG (figure 1A) demonstrates a regularly irregular rhythm at approximately 80bpm. There is a profound first-degree atrioventricular(AV) block with a PR interval of over 400ms. There is monomorphic ventricular ectopy in a right bundle branch pattern. The baseline QRS complexes are narrow.