Cardiology Case Report: Vomiting Yesterday

Our latest case report from Brady Pregerson, MD, features a man in his mid-60s presenting to the ED after his primary care provider referred him for 6 hours of vomiting that had occurred the day prior. Can you determine the correct diagnosis?

History: A man in his mid 60’s was sent to the urgent care by his PCP for 6 hours of vomiting that had occurred the day prior. He has had no further vomiting today but occasionally still feels a bit nauseous. He denies any fever, diarrhea, abdominal or chest discomfort, SOB, weakness other complaints.

Exam: Vital signs are normal. Other than obesity his physical exam is normal including clear lungs, no edema, and no abdominal tenderness.

An EKG is Done:

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