Presyncope, and a pulse of about thirty
This week's tracing
A 78-year-old woman is brought in after two episodes of feeling about to faint, both while standing at the kitchen sink. She did not lose consciousness and did not fall. She takes amlodipine and nothing else; no beta blocker, no rate-limiting calcium channel blocker, no digoxin.
She is alert and cool peripherally. Blood pressure 104/58, pulse felt at the wrist about thirty and regular. Chest is clear. Bloods, including potassium, are unremarkable.
What is going on here?
The answer to this tracing appears with the next post.
This tracing was generated, not recorded. It carries no patient data and no textbook copyright, and it opens in the studio with every dial live — move the rate, the axis, the ST segment and the conduction and watch the reading change.
Discussion
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