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Anterior wall Myocardial infarction with grave prognosis

Description

75 year old male present with acute onset of chest pain to ER. at presentation ECG was done. ECG suggestive of anterior wall Myocardial infarction with many interesting findings of grave prognosis. Sinus Ps@ 125/minute Ventricular escape @38/mt with RBBB with left axis deviation and left anterior fascicle block. There are ST Segment elevation in V1 V2 V3 V4 with symmetrical inverted T and pathological q waves. So final diagnosis of acute anterior wall Myocardial infarction with complete heart block, RBBB and left anterior fascicle block and left axis deviation. That is trifascicular block. Presence of qRBBB in anterior wall Myocardial infarction is associated with grave prognosis. Patient developed shock with ejection fraction of 20-25% and collapsed due to refractory cardiogenic shock.

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