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A 74-year-old woman presents to urgent care with epistaxis, controlled on arrival. She is also complaining of lightheadedness and fatigue that’s been going on for the past 2 weeks.

View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Figure 1: Initial ECG 
Case presented by Adam M. Woods, MD, PGY3, Chief Resident, The University of Texas Health Science Center at Houston.
74-Year-Old With Lightheadedness
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