Parallel Slopes
Report:
Sinus tachycardia 104/min
Intermittent second degree 2:1 AV block, possibly Möbitz 2
Intraventricular conduction defect, unspecified (? lead 2 strip)
Comment:
The tachycardia makes it very difficult to observe any increments in the PR intervals before the dropped P wave; there may not be any.
The P waves are well hidden, for their size, within the T waves. This is because their descending slopes are almost parallel. In the 5th and 6th beat of the top strip, there is no notching or bulging in the T waves. As the rate slows down in the bottom strip, the buried P waves make an obvious bulge on the descending limb of the T waves.[!xe "P wave:hidden, in T waves" \b \i!]
The patient died in cardiogenic shock.
Fig 130. 50 year old woman with known polyarteritis nodosa and hypertension.
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