What kind of AV Block?

Patient with chest pain. What is your diagnosis?

a)      STEMI infero-posterioris. Mobitz I
b)      STEMI infero-lateralis. Mobitz I
c)       STEMI inferioris. Mobitz II
d)      STEMI inferioris. Total AVB

e)      STEMI inferioris. NSTEMI anterioris. Second degree AVB


This ECG shows ST elevation in inferior leads that’s mean STEMI inferior is present.  Posterior STEMI is suggested by horizontal ST depressions, upright T Wave and tall R wave in right precordial leads.
PR interval is not constant. We can see progressive prolongation of this interval culminating with non conducted P wave, typical for second degree AVB, Mobitz I, that appear in P:QRS group with ratio 3:2 or 4:3.
Incomplete LBBB is present too.
Final diagnosis: a) STEMI infero-posterioris. Mobitz I

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