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    Mechanical Fall

    A 72-year-old woman presents to the ED for a wrist injury sustained after a fall. She states she fell because she lost her balance and did not feel weak or light-headed prior to the fall. She also states that she did feel “woozy” after she fell, but currently she denies any symptoms other than right wrist pain. She denies any chest pain, trouble breathing, or other complaints.

    Her examination is unremarkable except for a systolic murmur and a mild deformity and tenderness to her right wrist. Her skin is intact, her compartments soft, and distal neurovascular status is within normal limits. You administer 4 mg of morphine IV for pain and initiate a near-syncope work up because of her age just in case something else is going on.

    Laboratory results, including a CBC, metabolic panel, and cardiac enzymes are normal except for a white blood cell count of 11.3 x 103/µL. A wrist X-ray shows a distal radius fracture, which you splint and sling.

    Her ECG is shown below.

    What is your ECG read?

    Answer and discussion on next page>>

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