Cardiology Case Report: Chest Pain and Palpitations

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Our latest cardiology case report from Brady Pregerson, MD, features a man in his mid-60s presenting with chest pains and palpitations. Can you determine the correct diganosis?

History:
A patient in their mid-60’s with a history of CHF and MI presents to the hospital with chest pain and palpitations for the past hour. He also reports sweating and generalized weakness. He denies syncope, leg swelling or pain, fever, cough or other complaints.

Exam:
Vital signs are normal excepts for a pulse of 140 and BP of 108/85. The physical exam show mild diaphoresis, tachycardia, clear lungs, and no peripheral edema

An ECG is done:

Print out of an EKG strip from a patient with chest pain.|  Credit: Brady Pregerson, MD

Computer Read: Sinus tach at 142, short PR, PAC’s, PVC’s, LAD, LVH with QRS widening and repol abnormality, old interior and lateral infarcts
Credit: Brady Pregerson, MD

What is the most likely rhythm in this patient?


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