Cases in Electrocardiography
A 24-year-old woman with a history of type 1 renal tubular acidosis presented to the emergency department complaining of two days of headache, generalized weakness, and diffuse muscle cramping. The patient also noted the onset of nausea and vomiting over the past day.
She denied any chest pain, palpitations, shortness of breath, respiratory difficulty, cough, fevers, chills, diarrhea, or urinary complaints. At triage, her temperature was 97.1°F, pulse 71 bpm, blood pressure 98/68 mm Hg, and respiratory rate of 18 bpm.
Her examination revealed a non-toxic appearing young woman in no acute distress. Her pulmonary and cardiac examinations were unremarkable. On neurologic exam, she demonstrated intact sensation and motor strength, but had a slow gait. Given her nonspecific complaints, an ECG was obtained.
What is your diagnosis? See p. 26