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ne fone Pe 2 ee . My oye ~ NY 92-057 We are dealing witn degenerative heart disease including: A. Tne appearance of riggnt BB Block under observation as noted before, B. Cnanges in AV conduction which seem to vary although -Gigitalis nas peen given constantly and therefore Aamoarn anf +hea ceartal VIA anmnacs some Gamake a wll he et r egion Wo Uia appear probable, C. Changes in the RS-T level in chest leads from tne rignt whiecn hardly can be accounted for by other conditions although digitalis mignt confuse the issue nere but some anterior ischemic condition would appear probable, which i than before ‘except in Eleetrocardiogram: December 5, 1960 Sinus raytum, rate 72. Grade IJ AV Block: PR-2 equals 0,22 - 0,24 sec, There is a tendency to rignt axis deviation. As compared to November 26th, 1960. _In tne standard limb leads we still see the broad S waves in I and II related to the right BB Block observed before, In the augmented limb leads the general contour is the same aS it was. In tne chest leads we have a typical of late activation in Vl and beyond tnis. Tnere is still some elevation of RS-T in V2 and even in V3 but less than it was on November @ée@nd, and here I suspect that we are dealing with a coronary change. Wiether or not it has dome down as the result of dlgitalis or natural evolution cannot of course be determined but as noted, I have suspected some ischemic damage anterior in location, Beyond tnis the chest leads seem to be fairly similar to what they were and the same remarks apply to ths record as noted in regard to the preceeding one. Evidence of myocardial abnormality: 2 plus to 3 plus. oS, a ony 1 of ket FP 7