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Jason's Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013.

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Patient's clinical data:  This 12-lead ECG is from an adult patient of unknown age and gender (at the time of posting).  Active medications included Atenolol.  Patient's only complaints and symptoms were cramps and palpitations in the form of "an occasional extra beat".  This ECG was the patient's initial "baseline".  Based on what the patient's primary care provider (PCP) misinterpreted in this ECG, the patient ended up having an erroneous diagnosis listed among their "active problems".  Their computerized medical record that was never expunged of this bogus information.  A cardiac electrophysiologist was consulted and subsequently refuted the PCP's interpretation.

Questions:
1.  What might the patient's PCP misinterpreted this as?
2.  What is the actual interpretation?
3.  Is there any form or manifestation of AV block here?  If so, what is it?
4.  What is the primary disturbance of rhythm here?  What is a secondary finding to that primary disturbance?

http://www.amjmed.com/article/0002-9343%2858%2990309-7/abstract

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