This is another example of a right bundle branch block (see last week's Another RBBB ). RBBB is characterized by an rsR' or RsR' or rSR' in V1 and a late slurred s or S in V6 or I. The Tw axis is normally opposite in direction from the major terminal deflection of the QRS in both RBBB and LBBB. Here, the T wave axis is down in I, aVL, and V6 (aned to a leslead II) AND the terminal forces of the QRS are in the same direction. Further corroborating, the ST segment itelf is also depressed. This EKG is suspicious for ischemia of the apico-lateral wall.sr extent.
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!
