Abstract
PRESENTATION Preoperative assessment has been shown to decrease mortality and morbidity, especially in patients with multiple medical problems. One such examination uncovered an interesting finding in the electrocardiogram (ECG) of a 74year-old woman. The patient had a past medical history of chronic obstructive pulmonary disease, hypertension, and paroxysmal atrial fibrillation. She presented to the preoperative clinic for evaluation prior to her right hip replacement surgery. While her functional capacity had been excellent, recently, her activities had been limited due to increased hip pain. She denied any active cardiac symptoms such as chest pain, shortness of breath, or orthopnea. Her regular medications included aspirin and metoprolol. She also used an albuterol inhaler as needed.
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