44.A 58-year-old man is brought to the ED for a syncopal episode at din-
ner. His wife states that he was well until she found him suddenly slump-
ing in the chair and losing consciousness for a minute. The patient recalls
having some chest discomfort and shortness of breath prior to the episode.
His rhythm strip, obtained by EMS, is shown below. Which of the follow-
ing best describes these findings?
Chest Pain and Cardiac Dysrhythmias 23a. Mobitz type I
b. Mobitz type II
c. First-degree atrioventricular (AV) block
d. Atrial flutter with premature ventricular contractions (PVCs)
e. Sinus bradycardia
45.As you are examining the patient described in the previous question,
he starts to complain of chest discomfort and shortness of breath and has
another syncopal episode. His ECG is shown below. Which of the follow-
ing is the most appropriate next step in management?
a. Call cardiology consult
b. Cardiovert the patient
c. Administer metoprolol
d. Administer amiodarone
e. Apply transcutaneous pacemaker