Case 99: A 78-Year-Old Man with a Subdural Hematoma
History
Diagnosis
ECG 2
ECG 2 Diagnosis
History
A 78-year-old man had an episode of loss of consciousness at home during which he suffered from a subdural hematoma. This ECG is recorded in the Emergency Department:
Diagnosis
- Sinus rhythm, 75/min, with Mobitz II second degree AV block
- Ventricular rate 52/min
- Right bundle branch block and left anterior fascicular block (bifascicular block)
- Moderate voltage criteria for left ventricular hypertrophy
- Cannot rule out septal infarction, age undetermined (small Q-waves, V1-V3)
- T wave abnormality, consider inferior and anterolateral ischemia
ECG 2
This ECG is recorded in the ICU, 2 hours after the patient’s admission:
ECG 2 Diagnosis
- Sinus rhythm with high grade AV block
- Ventricular escape rhythm (ventricular rate 32/min)
- One AV-conducted beat, one fusion complex
ECG ID: E603