Cardiology Case Report: Tachycardia and Bradycardia

History: A man in his late 50’s presents to the emergency department with palpitations, which he describes as a rapid but regular heart rate. His fit bit has registered it up to 160 bpm at rest, whereas normally he is at about 80. He denies syncope, feeling light-headed, chest discomfort, dyspnea, fever, cough, any pain, melena, or other complaints. He also denies use of alcohol or recreational drugs.

Exam: Vital signs are normal except for a pulse of 142. BP is 139/87. Otherwise, vitals and physical exam are normal including no thyroid mass, tremor, pupillary abnormalities, or other findings.

An EKG is done

Computer Read: sinus tachycardia, inferior MI, probably old.