The patient is a 61-year-old man who presents to the urgent care center with lightheaded dizziness, which he says started several hours prior to arrival. He denies chest pain, syncope, and shortness of breath but says he feels “clammy.” He is not taking any medications on a regular basis has no history of myocardial infarction, but he had a stent placed 8 years ago.

Upon exam, you find:

General: Alert and oriented X 3, mildly tachypneic, skin color good but slightly moist

Lungs: CTAB

Cardiovascular: Tachycardic and regular without murmur, rub, or gallop

Abdomen: Soft and NT, no pulsatile mass

Ext: No peripheral edema, pulses are 2+ and equal in all extremities

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

A 61-Year-Old Man Who Is Lightheaded and Dizzy
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