Case 68: A 68-Year-Old Man with Mitral Valve Disease
History
Diagnosis
ECG 2
ECG 2 Diagnosis
Explanatory Diagram
History
This 68-year-old man with known rheumatic valvular disease had a mitral commissurotomy 7 years ago. He has moderate mitral stenosis and regurgitation. He is followed in the arrhythmia clinic:
Diagnosis
- Right arm-right leg lead reversal – This precludes the interpretation of the limb leads
- Atrial fibrillation with rapid ventricular response (114/min)
- Right bundle branch block
ECG 2
An ECG is recorded 2 days later, with correct lead placement:
ECG 2 Diagnosis
- Atrial flutter with variable AV block. Ventricular rate 125/min.
- Left axis deviation
- Right bundle branch block.
Explanatory Diagram
ECG ID: E301