ECG Quiz – Cardiology MCQ

This ECG shows:

(Click on the image for an enlarged view)

a) Anterior wall infarction

b) Anterior wall infarction with right bundle branch block

c) Anterior wall infarction with RBBB and atrial fibrillation

d) None of the above

Correct answer: c) Anterior wall infarction with RBBB and atrial fibrillation

The ECG shown above has an irregular baseline with no regular P waves, indicating atrial fibrillation. rSR’ pattern with T wave inversion is visible in the anterior chest leads. It may be noted that r waves are tiny while the R’ waves are prominent and slurred. The tiny r waves (poor progression of r waves in anterior leads) indicate anterior myocardial infarction as they are equivalent to q waves. Slurred R’ waves indicate the presence of a right ventricular conduction delay in the form of right bundle branch block (RBBB). Symmetric arrowhead inverted T waves also indicate myocardial ischemia. Read more…