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September 2020 Br J Cardiol 2020;27:100–1 doi:10.5837/bjc.2020.027

Twisting interval in complete heart block, cannot be overlooked: a challenging ECG dilemma

Mohsin Gondal, Ali Hussain

Abstract

Case A 56-year-old man was referred from the emergency department for further evaluation of recurrent dizzy spells. The patient reported that he had intermittent episodes of palpitations associated with pre-syncope, but denied loss of consciousness. Additionally, he was feeling generally unwell and tired. There was no associated history of shortness of breath, chest pain, nausea, vomiting or sweating. Each episode of dizziness lasted for a few minutes and occurred both at rest and on exertion. There was no history of recent viral infection, tinnitus, otalgia, or otorrhoea. There was no associated facial asymmetry, speech disturbance or sensor

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