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Answer for April 22, 2013

The inferior infarction (deep Q waves in 2, 3, and F) are obvious, and examination of the width and pattern of the QRS suggest right bundle branch block (RBBB). Unlike with LBBB, typical patterns of ischemia are usually recognizable in RBBB. A very subtle abnormality present here is reveral of the typical rSR' in V2 - here we have RSr'. This is the equivalent of the tall R wave in V2 and is probably due to posterior involvement of the inferior MI - thus an infero-posterior MI with a RBBB.

NOTE: EKG's are for internal educational purposes of the University of Massachusetts Department of Family Medicine. Please do not forward without permission from Dr. Golding!

April 22 EKG