A 56-year-old female with a past medical history of seronegative rheumatoid arthritis, fibromyalgia, hypothyroidism, and asthma presents to the emergency department for concern of "abnormal EKG" from the cardiology clinic. The patient states that she was previously told she has bradycardia and does endorse the occasional symptoms of palpitations, lightheadedness, and shortness of breath. She has a remote history of a stress test that was normal. The vital signs at time of assessment are shown: BP 151/74, HR 55, RR 20, O2 Sat 98% on room air. Laboratory testing in the emergency department is unremarkable and a chest x-ray showed no acute cardiopulmonary process. The patient had an EKG (Figure 1) completed in cardiology clinic.
Erica Dolph, MD, Michael Hohl, MD, and Ari Edelheit MD
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