ECG Challenge: Lightheadedness and Extremely Slow Pulse

Philip J. Podrid, MD


December 19, 2022

A 70-year-old man who has a history of coronary artery disease and ischemic cardiomyopathy with a left ventricular ejection fraction (LVEF) of 38% presents to the emergency department because of lightheadedness. His medications include a beta-blocker, an angiotensin-converting enzyme inhibitor, and nitrates (Imdur). His pulse is noted to be slow, and a 12-lead ECG is obtained.

Figure 1. Courtesy of Philip J. Podrid, MD


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.