ECG Challenge: Reflux or a Heart Attack?

Philip J. Podrid, MD


February 05, 2019

A 76-year-old man presents to the emergency department (ED) with a history of substernal chest pressure that occurred 2 days earlier. He thought that this was related to gastroesophageal reflux disease. The chest discomfort resolved, but he subsequently developed shortness of breath, and as a result he presented to the ED. At the time of presentation, his blood pressure was normal, lung auscultation demonstrated bibasilar rales, and a chest x-ray was consistent with vascular congestion. A 12-lead ECG was obtained.

Figure 1. Courtesy of Dr Podrid


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