ECG of the Week - 29th June 2015

This week's ECG case is from an 83yr old male who presented to the Emergency Department with several days of atypical chest pain with negative serial biomarkers. He had no relevant past medical history and was on no medication. The first ECG was taken on arrival to the Emergency Department the second ECG was perform when it was noted his heart rate has decreased suddenly. The patient remained asymptomatic during this period with normal conscious level, normal blood pressure and no chest pain or dysponea.

ECG on arrival to the ED
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ECG with heart rate change
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Things to think about

• What are the key features seen on these ECG's ?
• What historic / symptomatic features would it be important to establish in this patient ?
• What would you do with him ?