ECG Challenge: Lightheadedness and Extremely Slow Pulse

Philip J. Podrid, MD

Disclosures

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

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