A 90-year-old male with a known case of end-stage renal disease underwent an ECG due to experiencing dyspnea and chest pain.

The correct answer is “SA node block and Type 1 AVB”

The ECG demonstrates grouped beats. P-waves precede the QRS complexes with constant but prolonged PR intervals. This indicates a first-degree AV block.
Please note that P-wave is absent during the pause between the grouped beats. This pattern suggests an SA node block, rather than a second-degree AV block, in which a P-wave is present during the pause but is not followed by a QRS complex.

For more advanced users:
The P-P interval progressively shortens prior to the dropped P wave. The duration of the PP interval during the pause is less than twice the length of the shortest PP interval which is observed prior to the pause. This suggests a second-degree, Wenckebach sinoatrial block.

Special thanks to Dr. Salvatore for his expert ECG interpretation and the informative diagram he provided.

#extra8 ❤️

40 year old male with syncope

How does this ECG explain the symptoms?

Arrhythmogenic Right Ventricular Dysplasia
(ARVD)

A 75-year-old male with a known history of DM and HTN presented to the emergency department complaining of palpitations. Upon examination, his blood pressure was 140/90 mmHg, and O2 saturation was 94%.

The correct answer is “Junctional tachycardia with LBBB and PVCs
”

The ECG shows a repeating pattern of four beat groupings. In the first three beats of each group beat, the QRS complexes are wide and followed by retrograde P waves that come after the QRS, suggesting the beats start near the AV node (junctional tachycardia). The wide QRS complexes are due to underlying Left Bundle Branch Block (LBBB). The fourth beat in each group looks different, comes earlier than expected, and doesn't have a P wave after it, which indicates a Premature Ventricular Contraction (PVC).

65 y old male with a history of opium addiction found unconscious after two days.