It is a sunny January afternoon at the ER when you are called to see a 57 year old male complaining of feeling "really sick".
You find your patient lying in the bed in room 3. He looks pale and short of breath. You introduce yourself and ask him why he has come in today.
"About two weeks ago, I started feeling short of breath, with a cough. I got much more tired than usual. I went to see my doctor, who said I had an upper respiratory infection and prescribed me some antibiotics. I rested at home for a few days, and started to feel a little better. Then, I began to go downhill again. Felt so awful today, barely have enough energy to walk, so I had my wife drive me to the ER."
He tells you that he has a history of hypertension and is a pack a day smoker, although he is trying to quit., Prior to getting sick, he has felt pretty well. In fact, he tells you that he started a work out regiment to lose some of the excess weight he is carrying.
Your patient tells you he hasn't been eating or drinking well lately, and he is hypotensive at 86/58.
As you are running through your list of differentials, the tech hands you this 12 lead ECG:
You take a look at the ECG, and a couple of thoughts come to mind. You have an idea of what might have happened.
You tell Mr. Wilson that you want to run a few tests…
So, what do you think is wrong with Mr. Wilson?