HPI: A 54-year-old female presents to the ED with generalized weakness and malaise. She has multiple medical problems and is taking several prescribed medications including aspirin, metoprolol, and warfarin. She recently had an episode of acute gastroenteritis that has been improving over the past few days. She appears dehydrated and is found to be hypotensive (60/30) and bradycardic (20). The following ECG is obtained:
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