slowly, slowly…


76 year old female, presents with lightheadedness and lethargy. She is complaining of mid-scapular pain & is syncopal at triage.

She has cold hands & clammy skin. Systolic BP 70 mmHg. Crackles to mid-zones of her chest. Distended JVP.

PMHx: AF (on metoprolol) & rheumatic heart disease (?mitral stenosis)

This is her ECG.

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