A nurse hands you this EKG with a concerned look…
She say it’s a 35 y/o man who is coming in for shortness of breath and palpitations since last night. The next question you ask is vitals? Yes! BP 96/57, HR 201 ,RR25, pO2 99 on 4LNC and Afebrile. You put your thinking cap on and head over to see the patient.
He looks a little drowsy but is answering questions. He adds he has a history of “hole in his heart” repaired when he was 2 and 5 years old (two surgeries). He’s been well since, plays basketball with no issue. No clear chest pain. Denies drugs, caffeine, alcohol. Works nights in construction. He says nothing like this has ever happen to him.
Your superstar nurse comes by saying she’s found an old EKG, Hurray!
So, what current rhythm is this? What’s your next move?