The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain.
On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences.
View the ECG and consider what your next steps and diagnosis would be. Resolution of the case is described on the next page.