Acute chest pain in a patient with a known right bundle branch block (RBBB)

ECG Weekly Workout with Dr. Amal Mattu


 A 63-year-old male with multiple cardiac risk factors presents to a busy ED with chest pain. He has normal vital signs and a known right bundle branch block. The following ECG is obtained at triage and given to you to sign:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. Would you immediately bed the patient or send the patient to the waiting room?
  3. What is the most likely cause of this patient’s ECG abnormalities?