Anterior wall myocardial infarction with first degree AV block

A 48- year old male came with a history of acute onset retrosternal chest pain of 4 hours duration. The patient was a known case of Diabetes mellitus and hypertension. At the time of admission his Blood pressure: 100/70 mmHg, Pulse: 80bpm. ECG is shown below.

ECG

Source of the Image: Department of Cardiology, VMMC & Safdarjung Hosptial, New Delhi

ECG is showing sinus rhythm at 75bpm, LAD, PR: 240 msec, ST-segment elevation in  I, avL, V1-V6, ST-segment depression in lead 2,3 however depression in very minimal, narrow QRS, one VPC is seen in long lead ??RBBB  morphology 

Diagnosis: Acute anterolateral wall myocardial infarction with first degrees AV block

The patient was successfully thrombolysed with tenecteplase.

Thank You

Dr. Praveen Guta