ECG of the Month: Patient Admitted for Weakness and Lethargy

A 63-year-old woman presents with a history of hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease. She was recently found to have small-cell lung carcinoma and has started chemotherapy. Her medications include daily metformin and lisinopril. She has had diarrhea for the last 2 days, and she appears weak and lethargic.

The patient underwent an admission electrocardiogram (ECG) (Figure 1).

Figure 1

Figure 1

The patient's ECG demonstrates which of the following?

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