Case 18: A 58-Year-Old Man in the Emergency Department
History
Diagnosis
History
While in the emergency department for a laceration secondary to a motor vehicle accident, this 58-year-old man is noted to have an arrhythmia:
Diagnosis
- Sinus rhythm
- Mobitz I second degree AV block
- Atrial rate 90/min, ventricular rate 60/min
Every third P wave is not followed by a QRS (3:2 conduction). There is Wenchebach phenomenon: progressive lengthening
of the PR interval before the AV block occurs (Mobitz I – Remember: Prof. Wenkebach is #1!). In Mobitz I second degree AV block, the conduction abnormality is at the level of the AV node. 
ECG ID: E108