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Up is down, down is up: ectopic atrial bradycardia or junctional Rhythm?

Journal of Cardiology & Current Research
Belal Sultanzai, Ezra A Amsterdam

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A 63-year-old man with a history of chronic obstructive pulmonary disease and hypertension presented to the emergency department (ED) with stabbing left anterior chest pain while he was sitting on a bench. The episode lasted 5-10 seconds. The patient has a history of atypical chest pain; he is dependent on alcohol, is an active smoker and abused cocaine in the past. He has no other known cardiac risk factors except male sex and age. Medications: albuterol, tiotropium, and flunisolide.


ectopic rhythm, junctional rhythm, chronic, atrial tachycardia