ECG Case #45 - Question #2 Answer

He most likely has an aortic root abscess (annular abscess) which can be confirmed on transesophageal echocardiography and surgical intervention is required.

The aortic annulus is close the the AV node. The inflammation present when an aortic root abscess occurs causes the AV node to dysfunction. The first sign is a first degree AV block, then more advanced AV blocks can occur such as 3rd degree AV block.

PROCEED TO ECG CASE #46