Case 75: A 61-Year-Old Man with Endocarditis
History
Diagnosis
ECG 2
ECG 2 Diagnosis
ECG 3
ECG 3 Diagnosis
History
This 61-year-old man with multiple serious medical problems is referred to the Emergency Department by his family physician. He has had a fever for one week and his blood cultures are positive for streptococcus viridans. He has a loud murmur of mitral regurgitation:
Diagnosis
- Sinus rhythm with Mobitz II second degree AV block (3:2 AV conduction)
- Right bundle branch block
ECG 2
A second ECG is recorded 10 hours after admission:
ECG 2 Diagnosis
- Sinus rhythm with complete heart block
- Escape wide QRS rhythm, probably junctional rhythm with right bundle branch block
- Ventricular rate 42/min
ECG 3
An electronic pacemaker is implanted:
ECG 3 Diagnosis
- Electronic ventricular pacemaker (VVI)
- Underlying sinus rhythm with complete heart block
- Paced ventricular rhythm, 60/min)
ECG ID: E289