ECG Challenge: A 90-Year-Old Woman with Intermittent Lightheadedness

ECG Challenge: A 90-Year-Old Woman with Intermittent Lightheadedness

The patient is a 90-year-old woman who presents to urgent care with a 2-week history of intermittent lightheadedness. She denies syncope, chest pain, shortness of breath, diaphoresis, or focal neurological symptoms. Upon exam, you find: General: Alert and oriented X 3, sitting fully dressed in a chair Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT, no pulsatile mass Ext: No peripheral edema, pulses are 2+ and equal in all extremities …

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