JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
ECG CASE OF THE MONTH
Mental Disturbance for 4 Days
D. Luke Glancy, MD; Theresa Mills, MD; Fred Lopez, MD
A family brought their 61-year-old mother to the emergency department because for 4 days she had been confused, incoherent, and somnolent. She also had dysphagia, dysarthria, diplopia, and had fallen out of bed. She had been in the hospital 3 weeks earlier for atrial fibrillation and an exacerbation of congestive heart failure. She also carried a diagnosis of chronic obstructive pulmonary disease and used an albuterol inhaler. She was obese (BMI of 45) and had adult-onset diabetes mellitus. She had a 43 pack-year history of cigarette smoking but had recently quit. Soon after arriving in the emergency department, she had an ECG (Figure).
FIGURE: Admission electrocardiogram of a 61-year-old mentally disturbed woman. See text for explication.
What is your diagnosis? Explication is on page 59.
58 J La State Med Soc VOL 169 MARCH/APRIL 2017
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