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The patients is a 58-year-old male who presents with chest pain. He describes it as sharp, lasting seconds, and worsened by lifting objects at work.

Review the initial ECG taken and consider what your diagnosis and next steps could be. Resolution of the case is described on the next page.

ECG 1 - bifascicular block
Figure 1. Initial ECG.

(Case presented by Tom Fadial, MD, Assistant Professor, McGovern Medical School, The University of Texas Health Sciences Center of Houston.)

A 58-Year-Old Male with Chest Pain