EMS responds to a 90 year old male with a "possible stroke".
On arrival the patient is found sitting on the toilet (lid down). His spouse states that he had walked outside to retrieve the newpaper when he lost his balance and skinned his knee. She helped him inside and sat him down on the toilet in the bathroom when his eyes rolled back in his head and he started "shaking all over".
At the time of evaluation he is conscious, alert and oriented to person, place and time. He remembers falling while retrieving the newspaper but denies losing consciousness in the bathroom.
His skin is pale and diaphoretic.
He denies chest pain or shortness of breath.
Past medical history: Mild cognitive impairment, HTN, dyslipidemia
Medications: Metropolol, donepezil (Aricept), lovastatin (Mevacor)
Vital signs are assessed.
- RR: 16
- Pulse: 116
- NIBP: 115/53
- SpO2: 96 on RA
Breath sounds clear bilaterally.
Neuro exam: No facial droop, equal smile, clear speech. Slight pass pointing on the right side.
The cardiac monitor is attached which shows sinus rhythm, borderline sinus tachycardia.
A 12-lead ECG is captured.
What is your impression of this ECG?