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THE CARDIAC BOOTCAMP BLOG

70 year old male presents post collapse

11/15/2020

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A 70 yo male presents to the emergency department following a collapse at home. There is no prodrome and he does not remember the incident.
​His ECG is shown below. What is the diagnosis?
Picture
There is also a prolonged QTc of about 500. 
There is also a:
  • First degree block
  • RBBB
  • LAFB
I would call this a Trifascicular Block.
​
Cardiology argued that it was not. Read on to see why they were wrong.

What are the 3 Fascicles?

As the HIS Purkinje system enters the ventricular part of the heart it is composed of the:
  1. Right Bundle: which forms one fascicle
  2. Left Bundle, which is split into:
    1. Anterior and 
    2. Posterior fascicles
...Thus 3 fascicles.

If you want to find out about UNI/BI/TRIFASCICULAR Blocks as well as Complete and Incomplete Trifascicular Blocks become a Cardiac Bootcamp Course Member and become the expert.
Cardiac Bootcamp Course Members, go to the Fascicular Blocks page for more.
Become a Cardiac Bootcamp Course Member today and become the Cardiac Expert
It costs less than 2 cups of coffee a week

Author

Dr Peter Kas
MBBS MArch BArch FACEM

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    Dr Peter Kas

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