A 74-year-old man with a history of heart transplant presented with altered mental status. On admission, his blood pressure was 96/63 mm Hg and his heart rate was 72/min. On examination, he was in no immediate distress and had clear lung fields. There were no gallops on examination, and he had no focal neurological deficits. A median sternotomy scar and a left upper chest medical device were noted. The patient was unable to provide any history. His relatives confirmed prior heart transplant.
Badheka AO, Grover PM, Tanawuttiwat T, Badiye A, Marzouka GR, Patel NJ, Chaparro SV, Mitrani RD. Dual Ventricular Rhythm. JAMA Intern Med. 2013;173(13):1246-1248. doi:10.1001/jamainternmed.2013.7043a