Casos

58-year-old man carrier of revascularized coronary artery disease + mitral valve repair

Raed Abu Shama, M.D
Raed Abu Shama, M.D
Saudi Arabia

Case presentation

It is for a 58 yr old male with IHD, S/P CABG, MV Repair in 2016. Severe LV dysfunction, LVEF 20%. Presented with progressive HF symptoms. MPI was done and showed mild ischemia in the mid anterior wall and in the inferior wall. Echo showed severe MR despite excellent initial repair results. They showed me the ECG today and I said the following:
This is a rare form of true trifascicular block. There is RBBB + LAFB + LSFB (QRS duration 156 ms).
Do you agree or have other alternatives?
Thank you in advance for your help.

Questions

  1. Which is the ECG diagnosis?
  2. Which is the appropriate approach?

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Auspicios Institucionales
  • Sociedad Argentina de Cardiología
  • Federación Argentina de Cardiología
  • SIAC
  • SADEC
  • Asociación Argentina de Cardiología
  • SOLAECE Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología
  • Fundación Barceló - Facultad de Medicina