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Cardiology Case Report: Altered Mental Status and Shortness of Breath

Our latest cardiology case report from Brady Pregerson, MD, features an elderly man brought to the emergency department as a code STEMI from home for altered mental status and shortness of breath. Can you determine the correct diagnosis?

History: An elderly man is brought to the ED as a code STEMI from home for AMS and SOB. He recently recovered from pneumonia. He is too lethargic to give any meaningful history, but the wife says he has not been having any chest pain or other pain. He has a history of hypertension, treated with benazepril as well as a prior MI.

Exam: Vital signs are normal except for pulse in the 110’s.

An EKG is done:

What is the most likely cause of the EKG findings in this patient?