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Download the article PDF: Clinical Image Challenges October 2025

A 60-year-old male presents to urgent care with progressive dyspnea for 2 weeks associated with lower extremity edema. The patient is afebrile and slightly tachypneic with rales at the bilateral bases. An ECG is obtained.

View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Figure 1. Initial ECG.
Case presented by Benjamin Cooper, MD, MEd, FACEP, McGovern Medical School at the University of Texas Health Science Center at Houston
60-Year-Old With 2 Weeks of Dyspnea
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