Journal of Urgent Care Medicine

Practice Management

ECG Challenge: A 90-Year-Old Woman with Intermittent Lightheadedness

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The patient is a 90-year-old woman who presents to urgent care with a 2-week history of intermittent lightheadedness. She denies syncope, chest pain, shortness of breath, diaphoresis, or focal neurological symptoms.

Upon exam, you find:

  • General: Alert and oriented X 3, sitting fully dressed in a chair
  • Lungs: CTAB
  • Cardiovascular: RRR 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 and consider your next steps, along with possible diagnoses

ECG Challenge: A 90-Year-Old Woman with Intermittent Lightheadedness