Mr H. is a 64 year old man who presents for a pre-operative evaluation for an elective hernia repair. What are the findings on his EKG?
| Rate | 84 |
| Rhythm | Irreg Irreg. Absence of P waves. |
| Axis | LAD |
| Hypertrophy | LVH |
| Infarction | No significant Q waves or ST changes. |
Discussion
This patient has Atrial Fibrillation and Left Ventricular Hypertrophy.
The absence of P waves and irregularly irregular rhythm are consistent with atrial fibrillation.
LVH is easily apparent here, the S(V1) + R(V6) > 35mm, as well by other criteria. It explains the left axis-deviation, and the delayed-R-wave progression.
Review the LVH tutorial and rhythm tutorial.