The patient is a 60-year-old man with a 2-year history of dizziness. He denies chest pain, shortness of breath, diaphoresis, vomiting/diarrhea, or fever.
Upon exam, you find:
General: Alert and oriented
Lungs: CTAB
Cardiovascular: RRR without murmur, rub, or gallop, occasional irregular beats
Abdomen: Soft and NT without r/r/g
View the ECG taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.


Figure 1.

A 60-Year-Old Man with a 2-Year History of Dizziness
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