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A 61-year-old male presents to urgent care complaining of light-headedness. The patient has a medical history of hypertension and recently started metoprolol.

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

second-degree Mobitz I block ECG
Figure 1: Initial ECG.
Case presented by Benjamin Cooper, MD, McGovern Medical School, The University of Texas Health Science Center at Houston, Department of Emergency Medicine
61-Year Old With Light-Headedness