Make the Diagnosis: Dizziness Dilemma

(MedPage Today) -- Case Findings: A 42-year-old African American male presents with a report of dizziness and lightheadedness 3 days ago when he was standing up to go to the rest room. He denies any syncopal episodes. He has medically managed hypertension, hypercholesterolemia, and cardiomyopathy, and a last ejection fraction of 35% with defibrillator placement 4 months ago. His AICD did not fire during the dizziness episode. His last cardiac catheterization prior to AICD implantation revealed normal coronaries. The patient has been compliant with metoprolol 25 mg twice daily, lisinopril 10 mg daily, atorvastatin 40 mg daily. He denies any new medical regimen. His vital signs are BP 100/80 mm Hg and HR 66/min. His physical examination is normal without any clinical evidence of decompensation. What is best course of action based on what the ECG suggests?
via Make the Diagnosis: Dizziness Dilemma
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Make the Diagnosis: Dizziness Dilemma

(MedPage Today) -- Case Findings: The patient is a 42-year-old African American man who presents with a complaint of dizziness lightheadedness which occurred when he was standing up to go to the rest room 3 days ago. He denies any previous syncopal episodes. He has medically managed hypertension, hypercholesterolemia, cardiomyopathy with last ejection fraction of 35% with defibrillator placement 4 months previous. His ICD did not fire during the episode. His last cardiac catheterization prior to ICD implantation revealed normal coronaries. Patient has been compliant with metoprolol 25 mg twice daily, lisinopril 10 mg daily, atorvastatin 40 mg daily. He denies any new medical regimen. His vital signs are BP 100/80 mm Hg and HR 66/min. His physical examination is normal without any clinical evidence of decompensation. ECG is shown below. What is the next best course of action?
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