HPI
A 70-year-old woman with CHF, COPD, intermittent atrial fibrillation, chronic pain medication use, and recent poor intake develops sudden dyspnea at rest and is found somnolent and bradycardic in the 30s to 40s. Paramedics obtain a prehospital ECG showing apparent inferior ST elevation and activate the cath lab, but one feature on the tracing makes the receiving physician hesitate before proceeding.
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