Sloof Lirpa Sign

UMEM Potpourri ECG Cases with Dr. Amal Mattu


A 65-year-old woman presents to the emergency department with an episode of near-syncope. Her ECG shown below is interpreted by the ECG machine, an emergency physician, and a cardiologist as “normal sinus rhythm, new left bundle branch block with premature atrial contraction”. She is admitted to telemetry for a rapid ACS rule out, where she rules out, but later develops complete heart block and dies.

Before watching the video, ask yourself:

    1. What is your full interpretation of this ECG? 
    2. Are there any ECG findings that could have predicted her clinical deterioration?