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All ECG 5

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Source: Learn the Heart

The ECG shows sinus tachycardia at 100 beats per minute (bpm) with no evidence of atrioventricular (AV) conduction. The ventricular rate is 30 bpm. The ST segments are elevated 2-3 mm in leads II-III-AVF and there are Q waves in V2-3. The findings are consistent with an acute inferior-apical MI and complete heart block.

Ischemia of the AV node and enhanced vagal tone (partially though the Bezold-Jarisch reflex) may occur in the setting of myocardial infarction (MI), resulting in differing degrees of AV block. Complete heart block is much more common with inferior MI compared to anterior MI. In the reperfusion era, most patients recover normal conduction with supportive care after revascularization. 

Related: Third-Degree Atrioventricular Block ECG ReviewInferior MI ECG ReviewRight Bundle Branch Block ECG Review