From time to time, we may have an interesting ECG, but without enough information (including final diagnosis) or additional ECGs to make a full case study. In these instances, we will share the ECG and whatever information we have in our "Snapshot" series. As always, some information may be changed to protect patient confidentiality. Hope you enjoy!
Our first "Snapshot" involves a 58 year old male, with a chief complaint of epigastric pain. This pain has gone on for three days, and EMS is called by his girlfriend after "a couple" of syncopal episodes. Upon your arrival, he is alert and oriented, with an auscultated BP of 92/50, and a palpable radial pulse of 36. RR was 18, with an SpO2 of 95% on room air and clear lung sounds. He does, however, look anxious and is cool and diaphoretic. He complains of some shortness of breath, which he attributes to his epigastric pain. He has no significant medical history.
Here is the 12 lead ECG:
What do you think is going on here?
What would you do about it?