Musings in the life of an internist, cardiologist and cardiac electrophysiologist.
Monday, November 30, 2009
EKG DU Jour #19: A Case of Obtundation
A 60 year-old man was found obtunded, unable to ambulate or communicate at home by a house cleaning service. He was brought to the emergency room and found to by hypotensive, bradycardic and was intubated emergently due to poor ventillatory effort. His initial potassium was found to be 7.6 meq/L and a slow junctional escape rhythm of 40 b/min. He was administered calcium, insulin and glucose, and the EKG, shown below, improved a bit.
Click image to enlarge
An astute observer glanced at the EKG and posed an important question to the ER staff.
What was the question?
Addendum 18:45 CST - The EKG image was updated to permit better enlarged viewing.