History:  A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone.              

View the ECG taken and consider what your diagnosis and next steps would be.

(Case presented by Jonathan Giordano, DO, MS, MEd, The University of Texas Health Science Center at Houston/McGovern Medical School.)
A Patient on Dialysis with Syncope
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