All ECG 91
- Normal sinus rhythm
- Left atrial enlargement with P-mitrale pattern
- Premature ventricular contraction
This patient had severe mitral stenosis from rheumatic mitral valve disease causing massive left atrial enlargement.
Note the morphology of the PVC in lead V1. The R is greater than the R' in a right bundle branch block pattern which is one of the Brugada criteria for a ventricular origin of a QRS complex (see Ventricular Tachycardia review below).