Published: 8 May 2015
Author(s): Ashwini Sharma, Rehan Sarmad, Kenneth Wool
Section: Internal Medicine Flashcard

An 83y/o African American male with a history of hypertension and chronic kidney disease presented following a fall. The fall occurred while he was trying to get up from a sitting position. The patient said he was light-headed and his knees gave way, but at the time of history taking he was asymptomatic. He said he remembered the fall and did not lose consciousness. On presentation his vitals were normal. There were no signs of significant trauma or focal neurological deficits. His initial electrocardiogram (EKG) demonstrated sinus rhythm, rate of 89beats/min, prolonged QT interval, diffuse arrowhead T wave inversions, and minimal ST segment elevation in lead V1-3 which was alarming for ST segment elevation myocardial infarction (STEMI) (Fig. 1).

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