82 yo female, asymptomatic. What is your interpretation?

82 yo female, asymptomatic. What is your interpretation?
82 yo female, asymptomatic. What is your interpretation?
82 yo female, asymptomatic. What is your interpretation?

The ECG signs of complete left bundle branch block are;

  • QRS duration ≥120 msec
  • Broad, notched, monophasic R waves in V5 and V6, and usually in leads I and aVL
  • Small or absent initial r waves in V1 and V2, followed by deep S waves (rS or QS patterns) 
  • Absent septal q waves in left-sided leads (leads I, V5, and V6)
  • Delayed intrinsicoid deflection (>60 msec) in V5 and V6
  • Secondary ST segment and T wave changes (this waves directed opposite to the predominant deflection of the QRS complex)

There is also 1st degree AV block ( PR interval is ≥ 200 msec in 1st degree AV block, it is 240 msec in this particular patient.)