ECG Challenge: Sudden Palpitations and Shortness of Breath

Philip J. Podrid, MD


January 06, 2022

A 56-year-old man with a history of a reduced left ventricular ejection fraction (40%) due to a nonischemic cardiomyopathy presents to the emergency department with lightheadedness, shortness of breath, and palpitations. Physical examination is remarkable for a rapid heart rate, irregularS1 intensity, and irregular jugular pulsations with prominent cannon A waves. Bibasilar rales are present. An ECG is obtained.

Figure 1.


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