Our latest Emergency Department Minute Quiz from Brady Pregerson, MD. Can you determine the correct diagnosis?
History: A man in his 70’s w/ ESRD on peritoneal dialysis, type 2 diabetes, and diastolic heart failure presented to the emergency department for a 2-day history of dyspnea worse than his baseline dyspnea that started yesterday around 4 pm. He takes torsemide for CHF and denies any missed doses. His baseline is dyspnea after walking for 5 minutes, but today and yesterday he felt dyspneic walking between rooms at home. He endorses some mild abdominal distension, but denies any abdominal pain, fever, chills, new leg swelling, chest pain, or other complaints.
An EKG is done
COMPUTER EKG READ:
What is the most likely diagnosis?