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plaque disruption), the T waves still manifest markings of a previous state of suboptimal coronary flow that resolved: Type II supply-demand mismatch in the setting of extreme bradycardia. 2] Although the clinical context in today’s case does not fit these descriptors for Type I OMI (e.g. Phase IV block, or concealed transeptal conduction).
He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. 2021 Sep;49(6):488-500. He has 40 packs-year of smoking history. There was no premature cardiovascular diseases or sudden death in his family. 2021.21026.
To improve visualization — I've digitized the original ECG using PMcardio ) MY Thoughts on the ECG in Figure-1: This is a challenging tracing to interpret — because there is marked bradycardia with an irregular rhythm and a change in QRS morphology. Figure-1: The initial ECG in today's case. ( The QRS complex is wide ( ie, >0.10
Previously healthy, taking no medication and exercising regularly. No anginal symptoms asymptomatic during physical exercise. Below in Figure-5 is a 10-minute continuous lead II recording on oral Flecainide, now showing sinus bradycardia without a single PVC! Below in Figure-1 is this patient's admission ECG. No PVCs are seen.
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