Ecg contest ECG, December 2015

A 43-year-old man, originally from Ecuador, presented to his general practitioner with palpitations, denying symptoms of syncope or chest pain. He had a past history of untreated dyslipidemia and hypothyroidism on replacement therapy. His general practitioner performed an ECG with rhythm strip (Figures 1 and 2) and referred the patient for investigation to the regional cardiologist, who requested a 24-hour Holter (Figure 3) and transthoracic echocardiography (Figure 4), which showed mild ventricular dysfunction and an inferoposterior aneurysm.

Figure 1

Figure 2

Figure 3

Figure 4

Suggest a solution to this ECG Contest at http://www.revespcardiol.org/es/electroreto/68/12 (only Spanish) The answer will be published in the next issue (January 2016). #RetoECG.