ECG of the Week - 20th October 2014

This ECG is from a 70 yr old male who presented with general lethargy and postural dizziness. He has a collapse the evening prior and recently had a diarrhoeal illness.
His medications include warfarin, metoprolol, frusemide, allopurinol, colchicine and digoxin.



Vital signs on arrival in the Emergency Department were:

• GCS 14 
• BP 78/36 
• RR 16
• Temp 36.2 C

Click to enlarge

Exam Thoughts

Some things to consider give the patient's history and ECG findings:

• What would your immediate management be ?
• What investigations would you order ?
• What will be the patient's disposition and likely long-term management ?