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OE SCE tees hn eee 3 - nae | NY 92~057 Electrocardiogram: November 3, 1960 Sinus rhythm, rate 30-82, As compared to the record of November 2, 1960: In tue carlier record tnere is a slight degree of Grade I AV Bloc« «ivh PR~2 averaging 0,24 sec. Today I find one complc.x with a PR interval as short as 0,20 sec. but others vary up to 0.20 sec, and seem to average 0.22 sec. I believe that AV conduction is subno:mal and the condition is about the same. Again tnere is rizat BB Block of broad Sl type with some rignt axis deviation and again tnese features seem about the same. as they were before. Again there are low R waves in V4 particularly wnicn 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. The patient is getting digitalis but I do not note any cnanges due to tne drug wnich can be identified specifically. Evidence of myocardial abnormality: 2 plus to 3 plus, Infarction: f& 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. Electrocardiogram: November 9, 1960 Sinus rnytnm, rate 62-65. Tuere 18 a moderate degree of right axis deviation, Heart block of 2 kinds is present: Grade 1 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. Right BB Block of broad Sl type was first recorded in this series of records on July 12, 1960, Tne preceeding record of Marcn 2, 1900 did not slow right BB Block, However the previous records do give evidence of arteriosclerotic heart disease with coronary changes and a diagnosis of antaroseptal infarction was made at one time in 1959.