Electrocardiogram as an important tool in Preventive & Community Medicine - A rare case report of asymptomatic non paroxysmal accelerated junctional rhythm detected on routine ECG

Abstract

Fifty four year old asymptomatic employee was detected to have Inverted P waves with normal QRS complex on Electrocardiogram [ECG] during his Annual Medical Examination. The ECG reverted to normal after few days. Inverted P is suggestive of retrograde conduct of impulse from A-V Node. Case of Non Paroxysmal Accelerated Junctional Rhythm. Causes are inferior wall myocardial infarction, myocarditis or recent open heart surgery. Troponin T Test was negative, Treadmill test was negative, and 2D Echo showed 55 % ejection fraction with no regional wall motion abnormalities. It needs no treatment if underlying causes are ruled out. Case would have gone un-noticed as patient was asymptomatic, thus emphasizing the importance of ECG in preventive and community medicine.