Case presentation A 52-year-old man with a complete heart block was presented to the ED after being referred by his physician. Case history Earlier in the day, the patient complained of dizziness and extreme fatigue, for which his primary physician advised him to get an ECG. The results of the ECG test are shown in the below figure. The patient also reported that he experienced syncopal episodes in the previous week while camping, which he assumed was due to dehydration. The patient denied recalling any previous incidences of a tick bite.
However, he remembered having a rash about two months ago, which he attributed to contact with poison ivy. The rash resolved without any medical intervention. A month before this ED consultation, the patient experienced joint pain, which he assumed to be due to arthritis that had intensified due to the cold weather. Physical examination Heart rate: 48…
