A 58-year-old man presents with palpitations and dyspnea on exertion. Vital signs: BP 138/82 mmHg, HR 92 bpm, RR 18/min, temp 37.2°C, SpO2 98% on room air. ECG demonstrates an rSR-prime pattern in lead V1 with QRS duration of 128 milliseconds. Chest X-ray shows normal heart size. He denies syncope. Troponin is negative. He takes no cardiac medications. Which diagnosis best explains these findings?

  1. A)Atrial flutter
  2. B)Left bundle branch block
  3. C)Preexcitation syndrome
  4. D)Right bundle branch blockGABARITO
  5. E)Hyperkalemia

Explicação

Right bundle branch block classically produces an rSR-prime pattern in V1 with a widened QRS. Delayed activation of the right ventricle causes terminal rightward forces in the right precordial leads. Ver explicação completa e trilha adaptativa →

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