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46 year old man with right shoulder pain and dyspnea. History of alcoholism. No prior cardiopulmonary disease history.

Vent. rate 110 bpm
PR interval 136 ms

QRS duration 90 ms
QT/QTc 356/481 ms

P-R-T axes 58 141 3

Questions For Thought

1. What best explains all of the abnormalities in this ECG?
2. Does the ECG play a role in immediately establishing a differential for the patient's problem?

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