Cardiology Case Report: Generalized Weakness and Dyspnea

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This case report from Brady Pregerson, MD, features a woman in her mid-60s presenting to the ER with generalized weakness and dyspnea. Can you determine the correct diagnosis?


A patient in their mid-60s with a history of COPD on home oxygen, recurrent pyelonephritis, and GERD on a PPI presents to the ER with generalized weakness and her baseline level of dyspnea. She denies any current diarrhea, dysuria, fever, chest pain, or other complaints.


Vital signs are normal. The physical exam is normal except for bilaterally diminished breath sounds consistent with advanced COPD.

Patient ECG:

What is the most likely cause of the ECG findings in this patient?