Worsening Dyspnea

The patient is an 80-year-old male with a history of diabetes mellitus type 2, end stage renal disease, chronic obstructive pulmonary disease (COPD), and lung cancer with recent radiation therapy. He is seen in the emergency department because of marked increase in dyspnea and fatigue.

Figure 1

An electrocardiogram (ECG) is performed and shows which of the following?

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