Male in his 50’s resuscitated from ventricular fib and comatose
After resuscitation, he had this ECG (the rhythm is interesting, too): There is sinus rhythm but the sinus rate is somewhat irregular…
Right Bundle Branch Block with New Anterior ST elevation
An elderly female with no known history of CAD presented to the ED as a walk-in with vomiting and upper abdominal discomfort. The…
Chest Pain and Right Bundle Branch Block. What is the Diagnosis?
A male in his 70’s with no h/o MI or CAD presented with new onset chest pain. Here is his ED ECG: There is sinus rhythm and right…
ST depression, pulmonary edema, and severe hypertension: is this demand ischemia or acute coronary syndrome?
This middle-aged patient has a history of CVA and hypertension. He presented with a two hour onset of pulmonary edema and chest…
A Child with Blunt Trauma
A 6 yo girl had significant trauma from an MVC, with head injury (initial GCS 10, but no intracranial bleeding) and mild orthopedic…
What is the Diagnosis?
A 60 yo woman presented with CP and troponin I of 0.85 ng/ml. There is RBBB, but without the usual rSR’ in right precordial…
RBBB with dynamic T-waves
56 y/o male who presented with 12/10 severe chest pain starting at 3AM, radiating to his upper back. He had a history of pulmonary…
Is This a Simple Right Bundle Branch Block?
A 72 year old male presented in shock. Here is his initial ECG: There is a wide complex at 194 ms, with RBBB. Anything else? Here is his…
Left ventricular Aneurysm Morphology Distorted by Right Bundle Branch Block, Mimicking Acute STEMI with RBBB
This is a complex case that I have reprinted from my article in the EMRA publication, EM Resident, with their permission. I’m…
Bizarre T-wave inversion of Stokes Adams attack (syncope and complete AV block), with alternating RBBB and LBBB
This is a 68 yo male with a history of aortic stenosis, on carvedilol, fell from a ladder approx 20 ft onto concrete, landing face down with…