A 74-Year-Old Man with Epigastric Pain

Case
The patient is a 74-year-old man who complains of epigastric pain. He is an alcoholic who has had multiple episodes of pancreatitis. He has no chest pain, shortness of breath, or diaphoresis. An ECG is performed by staff prior to provider evaluation.

Upon exam, you find:
General: Alert and oriented
Lungs: CTAB
Cardiovascular: RRR without murmur, rub, or gallop, occasional irregular beats
Abdomen: Soft and NT without r/r/g
View the ECG taken and consider what the diagnosis and next steps would be. Resolution of the case id described on the next page.

Figure 1.