A young lady was found unconscious by her parents while she was exercising. She was rushed to emergency medicine depament where her blood sugar levels were repoed to be 250 mg/dl. No history of diabetes was there. ABG analysis was suggestive of metabolic acidosis. Thus, diagnosis of DKA was made. The patient was managed and gradually she improved as well. Her ECG is given below. Where is the pathology likely located in hea of the patient in above clinical scenario?
The ECG shows: PR interval progressively increases from one complex to the next. The Wenckebach pattern here is repeating in cycles of 5 P waves to 4 QRS complexes (5:4 conduction ratio). The increase in PR interval from one complex to the next is subtle. However, the difference is more obvious if you compare the first PR interval in the cycle to the last. The P-P interval is relatively constant despite the irregularity of the QRS complexes. A young person actively involved in spos usually have dominant vagal tone. Here, Wenckebach pattern is likely which is usually located anatomically to AV node.
AV Node
His bundle
Left bundle branch
SA node
Integrated QBank