Case 4

A 64 year old man presents to the ED complaining  of feeling dizzy, short of breath and ‘as if my heart is going to beat out of my chest’.

His past medical history is notable for an MI 6 years ago, which was treated with PCI.

The triage nurse record the patient’s vital signs which are opposite and performs and urgent ECG which is shown below:

HR 167bpm

BP 135/78 mmHg

RR 18

SpO2 95% RA

Temperature 37°C

GCS 15