The patient is a 44yo male with dalysis-dependent end-stage renal failure who presents with chest tightness and weakness.
The EKG shows bradycardia with no P waves (SA node arrest). It also shows a wide QRS with a LBBB morphology…either junctional escape with a block or an idioventricular escape rhythm. The T waves are tall and peaked. The QT is prolonged as well. The patient’s potassium was found to be elevated at 7.0. He was treated with calcium gluconate, insulin/D50, and bicarbonate, and was dialyzed emergently.
