Our latest case report features a man in his mid-80s with hypertension, pleural disease, and AF, presenting with 2 days of chest pain radiating to his upper back. Check out the EKG and see if you can determine the correct diagnosis.
A man in his mid-80’s with hypertension, pleural disease and atrial fibrillation on rivaroxaban and carvedilol presents with 2 days of chest pain radiating to his upper back. He describes his pain as constant, waxing and waning, 8/10 in severity and worse with deep inhalation or lying supine. He has had a very slight cough but denies fever, flu or shortness of breath. He also denies diaphoresis, nausea, vomiting, abdominal pain, leg swelling, palpitations or other complaints.
Vital signs and physical exam are normal except for an irregular heart rate.
What is the most likely cause of the EKG findings in this patient?