Cardiology Case Report: Tenesmus

History:

A patient in his mid-80s presents to the hospital with rectal bleeding for one day, just one episode but ongoing tenesmus. He also feels a bit light-headed and is noted to be bradycardic but denies being on any medications for blood pressure or for his heart. A review of his medications shows not beta or calcium blockers or anything else that should cause bradycardia. He denies syncope, palpitations, chest pain, SOB, leg swelling or pain, fever, cough, or other complaints.

Exam:

Vital signs are normal except for bradycardia. The physical exam is normal except for guaiac-positive stool.

An ECG is done