ECG of the Week – 18th September 2019

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An 83 year old lady presents with palpitations preceeded by central chest pain.

Her GCS is 15 but her BP is unrecordable.

Her ECG is as below.

Questions:

  1. Describe her ECG.
  2. What are the indications for DC Cardioversion?

You decide to go ahead with DCCV and are successful in reverting her to normal sinus rhythm. Her ECG post DCCV is below:

  1. What is the main abnormality, and a differential cause for this?
  2. How would you investigate further?