A 32-year-old woman with a history of smoking presented to the hospital with complaints of mild chest pain that started 16hours prior to arrival during a bike ride. Vital signs on arrival at the Emergency Department were blood pressure 103/52, pulse 85 bpm, respiration 14 breaths per minute, and oxygen saturation 99%. The initial electrocardiogram was recorded (Figure).

Figure

(0.4MB).

What do you think is the correct diagnosis?

• 1)

  Pre-excitation syndrome (Wolff Parkinson White syndrome)

• 2)

  Accelerated idioventricular rhythm

• 3)

  Atrioventricular dissociation (complete atrioventricular block)

• 4)

  Early phase of anterolateral ST segment elevation myocardial infarction

Suggest a solution to this ECG Contest at http://www.revespcardiol.org/en/electroreto/71/11. The answer will be published in the next issue (December 2018). #EKGchallenge.