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This ECG shows a patient with an underlying sinus rhythm. The patient then has a very prolonged pause which was longer than four times the normal P-P interval. This is an example of a sinus arrest. The patient also has some very impressive ST segment elevation. Evaluation with a full 12-lead ECG is indicated to evaluate the possibility of an acute MI. Clinical correlation is also indicated to evaluate the patient's hemodynamic status because of the possible MI and the sinus arrest.
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