Case 2
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Question 1 of 2
1. Question
A 65-year-old woman presents with a 4-day history of dizziness, shortness of breath and recurrent collapse. She has a history of fast atrial fibrillation with a normal recent echocardiogram. Her current medication is Bisoprolol 10 mg o.d. and Diltiazem 180 mg b.d. Her Diltiazem dose was increased from 120 mg b.d. 2 weeks ago.
On arrival, she drowsy, has a pulse of 43 with a BP of 65/40. She has bibasal crepitations on chest auscultation. 1.2 mg of intravenous atropine has had no effect. Her ECG is below.
Click the ECG to see a larger version.
Fig.9 via LITFL
What does the ECG show?
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Question 2 of 2
2. Question
What has probably caused this problem?
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