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An 84 year old Caucasian male with multiple medical problems including heart disease is brought into the ED from the nursing home as a medical notification. The floor nurse in the nursing home reports that he has a change of mental status. On exam, the patient is minimally responsive. He appears moderately dyspneic.
Rate: 45 Rhythm: regular, except between 2nd and 3rd beat Axis: left axis PR: absent p waves QRS: borderline wide (0.12-0.14) ST: no elevation or depression Additional waves: U waves in V1 thru V4
EKG diagnosis: Junctional escape rhythm
Clinical diagnosis: Altered mental status secondary to cardiac arrhythmiaàdecreased cardiac outputàdecreased perfusion of brain
Bonus question: As per Master Yoda, what 3 things feed the dark side of The Force?
- 1) Anger
- 2) Fear
- 3) Aggression
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