Sunday, May 25, 2008

Sunday May 25, 2008


Q; 84 year old female admitted with syncope and frequent episode of hypotension. Following EKG is obtained. What is your diagnosis (Hint - 3 marked circles) and what intervention is required in view of hemodynamic instability?




A: This is 'trifasicular' block

  1. Complete Right Bundle Branch Block (red)
  2. Left Anterior Hemiblock (Green)
  3. Long PR interval - first degree AV block (blue)


In view of hemodynamic instability, a temporary or may be a permanent pacemaker is needed.