Multiple Choice Challenge: 2 Answer C, is not wrong. In an | Figure 1

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Multiple Choice Challenge: 2

Answer C, is not wrong.

In an emergency, all you need to say is that there’s a complete heart block since it tends to portend imminent hemodynamic collapse secondary to ventricular fibrillation

However...

Is it a complete heart block? Technically, no. But there is a complete heart blocking a sinus tachycardia, resulting in a junctional escape rhythm which is keeping the patient alive

It is important to acknowledge that the patient is still alive (!) with an escape rhythm, and also what the block is blocking

You need a 12-lead to properly diagnose ST deviations, but what if you don’t get that far? The rhythm strip ‘seems’ to show ST elevation in lead II. What is causing the heart block? Inclement weather? No, it obviously an inferior MI. It’s anatomically consistent; a compromised RCA often causes heart block. So, in an emergency, I argue that you CAN diagnose an MI with a rhythm strip (provisionally)

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