A 21-year-old woman is transported to the emergency department from a night club by ambulance for a possible panic attack. Medics state that she had been drinking and had just finished dancing and was walking off the floor when she suddenly experienced a rapid heartbeat and panic followed by a syncopal episode. A boy she had met that night caught her so there was no injury. The patient denies any chest pain, drug abuse or other complaints.
Vital signs were normal including heart rate, blood pressure and temperature.
Physical examination was normal as well, including pupils, thyroid palpation, heart rate, lungs, and neurologic exam.
- Spiking of drink
- CBC, beta HCG, chemistry and toxicology results were all normal
- ECG (see results in Figure 1, above)
- What does the EKG show? (Figure 1; click to enlarge)
- What should you do next?