EMS is called to a tennis club to assess a 39 year old male who experienced a syncopal episode while playing tennis.
On arrival, the patient is lying down on the ground next to a bench. He appears lethargic and pale. Bystanders are laying ice cold towels around his head and chest and tell you they think he’s suffering from heat exhaustion.
Radial pulses are slow and barely palpable.
The patient is transferred to the gurney and the patient is relocated to the back of the ambulance.
The patient is oriented to person, place, and time. He does not remember fainting but understands that it occurred.
He admits to mild chest discomfort and nausea.
Past medical history is significant for Hodgkin’s Lymphoma.
Vital signs are assessed.
SpO2: 100 on RA
The cardiac monitor is attached.
SpO2: 100 with supplemental O2
What do you think is going on with this patient?
*** UPDATE ***
By popular request, here’s the 12-lead ECG captured after the rhythm change.