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81 year old woman presents with substernal chest pain. History of hyperlipidemia. She had a narrow QRS on an ECG in 1987.

Vent. rate 116 bpm
PR interval 178 ms

QRS duration 152 ms
QT/QTc 410/466 ms

P-R-T axes 83 -10 71

Questions For Thought

1. The QRS is wide. Does this represent a bundle branch block?
2. Can you diagnose ischemia or infarction from this ECG?

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