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Case Report: DOE

Our latest case report from Brady Pregerson, MD, features a man in his early 60s presenting with months of gradually worsening dyspnea on exertion that has been worse for several days. Check out the EKG and determine the correct diagnosis!

History:

A patient in their early-60’s with no PMH presents to the hospital with 2 months of gradually worsening dyspnea on exertion that has been worse for the past few days. He thinks the trouble breathing may be an allergic reaction to a new skin cream he is using because the timing seems to fit. He denies syncope, palpitations, chest pain, leg swelling, or other complaints.

Exam:

Vital signs are as follows: Temp 98.8, BP 115/73, HR 112, RR 21, Sat 92%. Exam is otherwise normal with no rash, leg swelling, stridor, or wheezing/rales.

Testing:

CXR: clear with normal heart/mediastinum

An EKG is performed:

What is the most likely diagnosis?