ECG Response: March 25, 2014

Abstract

ECG Challenge: A 72-year-old man with a history of chronic obstructive pulmonary disease presents with an increase in shortness of breath that began 2 weeks ago after experiencing an upper respiratory infection presenting with a cough productive of yellowish sputum, pleuritic chest pain, and a low grade fever with temperatures of up to 100°. He did not seek medical attention, but because of worsening shortness of breath he presented to the emergency room. On physical examination he has bilateral rhonchous sounds and wheezing. A chest x-ray showed evidence of chronic obstructive pulmonary disease with hyperaeration and fibrous streaking. His O2 saturation was 88% on room air. He was placed on supplemental O2 via a nasal cannula at 4 L/min. He received albuterol therapy via a nebulizer. Shortly after his first treatment he was noted to have a transient increase in heart rate and an ECG was obtained. The first 4 QRS complexes have a …