Abstract
Scenario: This ECG (V1 top and lead II bottom) was obtained from a 78-year-old female patient admitted to the cardiac intensive care unit 3 weeks earlier. She was admitted with respiratory distress and is currently intubated via a tracheal tube, on phenylephrine hydrochloride for blood pressure control, is in septic shock, and requiring dialysis every other day. She has an extensive clinical history including: hypertension (HTN), coronary artery disease (CAD), prior myocardial infarction (MI), heart failure (HF), chronic obstructive pulmonary disease, type II diabetes, hypothyroidism, and chronic kidney disease. The patient is nonresponsive so subjective symptoms could not be ascertained. Her blood pressure dropped from 108/60 to 85/43 during this rhythm. A regular feature of the American Journal of Critical Care, the ECG Puzzler addresses electrocardiogram (ECG) interpretation for clinical practice. To send an eLetter or to contribute to an online discussion about this article, visit www.ajcconline.org and click “Respond to This Article” on either the full-text or PDF view of the article. We welcome letters regarding this feature.
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