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A 66-year-old male presents in the urgent care, saying “it’s hard to breathe.” He’s had weakness and dyspnea for one day. The patient has a medical history of diabetes, hypertension, and heart failure. The patient has a pacemaker. An ECG is obtained.

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

Figure 1.
66-Year-Old With Weakness and Dyspnea