History
This patient had complete heart block, with 30% left ventricular ejection fraction (LVEF) visualized on echocardiography. A temporary pacemaker wire was inserted into the right ventricle via femoral venous access. Coronary artery angiography was performed, ruling out coronary artery disease. The patient was scheduled for a biventricular pacemaker.
Current Medications
The patient was taking carvedilol 6.25 mg twice daily, digoxin (Lanoxin) 0.25 mg daily, furosemide plus spironolactone (Lasilactone) 25 mg twice daily, and enalapril 2.5 mg twice daily.
Current Symptoms
The patient was experiencing symptoms consistent with New York Heart Association (NYHA) class III symptoms.
Physical Examination
Laboratory Data
Comments
The patient’s hematologic and chemistry values were normal.
Electrocardiogram
Findings
The patient had a left bundle branch block and a QRS duration of 140 ms.
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