Image 4. EKG obtained subsequently revealing complete heart block(P waves and QRS complex are not related to each other in lead V1). Also right bundle branch block pattern and pseudo-Q waves may be noted in anterolateral leads

From

Rapid Progression of Heart Failure in a Patient with Idiopathic Inflammatory Myopathy

Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Abdullah Mahmood, Mitchell Hare, Nicholas Taklalsingh, Isabel M. McFarlane

American Journal of Medical Case Reports. 2018, 6(8), 157-160 doi:10.12691/ajmcr-6-8-3