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Pathology 47

A 68-year-old woman presents to the emergency department with chest pain, dizziness, and shortness of breath for the past 3 hours. She denies fever, nausea, vomiting, diaphoresis, or palpitations. Her past medical history consists of myocardial infarction one week prior as well as hyperlipidemia, stage 2 chronic kidney disease (CKD), and hypertension. Current medications include atorvastatin, ticagrelor, aspirin, valsartan, and metoprolol which have all been taken consistently at appropriate doses. Her family history includes atrial fibrillation and myocardial infarction at 75 years old in her father. She does not drink alcohol, smoke cigarettes, or use any recreational drugs. Vital signs are temperature 37.1° C (98.6° F), blood pressure 78/42 mmHg, pulse 125 beats/min, 97% O2 saturation, and respirations 18/min. On physical examination, she exhibits distension of the jugular veins, faint heart sounds on auscultation with no gallop or murmurs, and 1+ pitting edema in the legs to the level of the shins.

Which of the following findings is most likely to be seen on the patient’s electrocardiogram?

  • A) Low voltage QRS complexes with alternating heights
  • B) Presence of U waves
  • C) Prolonged QT intervals
  • D) ST segment elevations in the anterolateral leads
  • E) T wave inversions

Author(s)

Pathik Wahi

Editor(s)

Dr. Ted O'Connell

Last updated

Jan 29, 2025

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