Inferior Wall M.I. With Third-degree AV Block
This ECG was obtained from an elderly woman who suffered a complete right coronary artery occlusion and inferior wall M.I. In her case, the AV node was also affected, and she developed a third-degree AV block with a junctional escape rhythm. A good ECG for ACLS classes as well as for ECG classes. A lively discussion can be had regarding "types" of complete heart block and the nature of the escape rhythm - when to treat and when to leave the rhythm alone. In this case the rate of the junctional escape rhythm was adequate for perfusion, and the patient's blood pressure was stable. Priority for treatment in this situation is restore blood flow through the coronary artery, if the patient is a candidate for PCI. You might want to review Christopher Watford's contribution to the Ask the Expert page on AVB vs. AV Dissociation.
