Cardiology Case Report: Indigestion

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Our latest case report from Brady Pregerson, MD, features a woman in her mid-80s with a history of breast cancer presenting to the hospital with a burning sensation in her chest for the past 3 days she describes as feeling like indigestion. Can you determine the correct diagnosis?

History: A woman in her mid-80’s with a history of breast cancer presents to the hospital with 3-4 episodes a day of chest burning that feels like indigestion occurring daily for the past 3 days. The episodes are not triggered by food or activity and last about 30 minutes at a time. When she takes Maalox she states they seem to go away more quickly. She denies any nausea, vomiting, palpitations, pain, SOB, fever, cough or other complaints. She went to a minute clinic and they sent her to the ER for an irregular heartbeat.

Exam: Vital signs are normal except for slightly elevated BP.Her abdomen is non-tender

An EKG is done

EKG strip from a patient experiencing an acute coronary syndrome.

Computer Read: NSR with occasional PVC, T wave abnormal, consider ischemia, long QT (489ms).

What is the most likely cause of the EKG findings in this patient?


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