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2 ome NY 92~057 Electrocardiogram: November 3, 1960 OR URI tM oe Sinus rhythm, rate dO0-S2. 2 As compared to the record of November 2, 1960: i $ In tue earlier record tnere is a slight degree of Grade I ~. # AV Block .ivh PR~2@ averaging 0,24 sec. Today I find = one compl«.x with a PR interval as short as 0,20 sec. hoe but otners vary up to 0.20 sec, and seem to average Re 0.22 sec. I believe that AV conduction is subno:mal and the condition is about the same. Again tnere is rizgat BB Block of broad S51 type with som rignt axis deviation and again tnese features seem about the Same. as they were before. Again there are low R waves in V4 particularly whicn strangly suggest a coronary background as I do not believe these can be explained as ! incidental to the zone of transition altnough that could be a factor. Tne patient is getting digitalis but I do not note any cnanzes due to tne drug wnich can be identified specifically. Evidence of myocardial abnormality: 2 plus to 3 pilus, Infarction: A coronary background is probably as noted before but I am unable to see changes which might suggest an active process However we must remember that any * form of BB Block might mask such a process. a j= - Electrocardiogram: November 9, 1960 Sinus rnytnm, rate 82-85. There 15 a moderate degree of right axis deviation, Heart block of @ kinds is present: Grade I AV Block as PR-2 equals 0,22-0.24 sec, This might: be due in part to digitalis but has been present earlier and suggests some damage in the septal region. Rigiit BB Block of broad Sl type was first recorded in this series of records on July 12, 1960. Tne preceeding record of Maren 2, 1900 did not slow right BB Block, However the previous records do give evidence of arterioseclerotic heart disease with coronary changes and a diagnosis of antaroseptal infarction was made at ene time in 1959, ~ Omer. Ne oes a t UJ t / G 2