A 52-Year-Old Man Who Is Lightheaded and Dizzy

Case

The patient is a 52-year-old man who presents to your urgent care center with lightheaded dizziness, which he says has been present for the past 3 days. It is worse with standing. He reports that he has been spending a lot of time in the sun lately. He denies chest pain, shortness of breath, abdominal pain, or paresthesias. He does not take any medications. His personal medical history untreated hypertension, and there is a family history of heart disease. Upon examination, you find:

• General: Alert and oriented, NAD, WNWD
• Lungs: CTAB
• Cardiovascular: Tachycardic and regular without murmur, rub, or gallop
• Abdomen: Soft and NT, no pulsatile mass
• Ext: No peripheral edema, pulses are 2+ and equal in all extremities

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