Beyond Left Bundle Branch Block

A patient in their 80s with a history of atrial fibrillation, hypertension, and hyperlipidemia presented to a rural hospital with sudden-onset chest pain and shortness of breath. For the prior few weeks, the patient had had intermittent chest pain that resolved with rest but was now persistent. The patient had no history of coronary artery disease (CAD). The physical examination was notable for tachycardia, 3/6 mid systolic ejection murmur, and significant pedal edema. An electrocardiogram (ECG) was obtained.