We met an elderly patient who had a history of hypertension and diabetes. He was admitted with complaints of dizziness and a “feeling of slow heart beat” for the past 2 weeks. He also had 1 episode of a presyncopal event and an electrocardiogram indicating third-degree atrioventricular block. This seemed like a straightforward admission. By the time we first met the patient, cardiology had already decided to place a pacemaker. During rounds, we asked what could be the cause of this patient’s bradyarrthymia. We sat down with the patient and talked to him to gather more pieces of the puzzle.
Salomon S, Fausto J. Unnecessary PacemakerCare Coordination Problems and Language Barriers. JAMA Intern Med. 2015;175(4):487. doi:10.1001/jamainternmed.2014.7690