ECG Challenge: Intense Chest Pain and Irregular Pulse

Philip J. Podrid, MD


August 20, 2020

A 64-year-old man with a history of a previous myocardial infarction presents to his primary care physician with complaints of chest discomfort that is pleuritic and nonexertional. The pain is localized to the right side of the chest. Vital signs are stable and his physical examination is normal except for a systolic sound at the lower left sternal border that is brief and intermittent. A chest x-ray is unremarkable. Pulse is irregular, and a 12-lead ECG is obtained.

Figure 1. Courtesy of Dr Podrid.


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