So let's get the obvious questions out of the way
How does she look?
-She looks better than her vitals. Moderate distress, but alert and talking.
What's she complaining of?
-She's not complaining of anything, but acknowledges feeling lightheaded and mildly dyspneic when asked.
Anything that immediately pops out to you on physical exam other than bradycardia?
-There's nothing like a cantaloupe sized mass growing out of her neck or an arrow stinking out of her chest. Bradycardia is definitely the most salient exam finding. Further findings will be provided if you ask for them, but many were not needed/relevant for the diagnosis.
What's her medical hx?
-It's HUGE. See next post.
What meds is she on? Is she on digoxin or beta blockers?
-Her med list is even more bigly than her PMH - it's YUUGE. I'd have to access the EMR, and will do so tomorrow. Digoxin is a good thought, and I specifically looked for it on her list. She is not on Digoxin. She is on INH, however - don't see that one every day.
And then obviously, what's the ECG demonstrate?
-I'd like to post an image, will try to do so when I get back to work tomorrow. But for now I'll tell you that the EMS strip looked like complete heart block. The ED ECG looked more like a fib with slow ventricular response.
