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Answer for March 11, 2013

This patient is in sinus rhythm with a 1st degree av block. There is probably an interventricular conduction delay (QRSd 0.11 seconds), and an old inferior MI (Qw 3,F). Poor R wave progression may point to an old anterior MI, or more likely pulmonary disease (persistent S wave V5, V6) or cardiomyopathy. However, the urgent finding is the peaked/pointy T waves across the precordium, suggestive of hyperkalemia. The patient's chronic medical condition is CRF.

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!

March 11 EKG