Image of the Week: Subacute shortness of breath and fatigue in a 70-year-old man

A 70-year-old man is brought to the emergency department with subacute shortness of breath and fatigue. After searching her father’s home, his daughter reports that she found his medication—a nearly-empty bottle of metoprolol, 100 mg bid. She believes her father has coronary artery disease. On examination, the patient is confused. His blood pressure is 69/49 mmHg and he has a heart rate of 48 bpm. An ECG reveals the findings [Figure 1]. After initiating oxygen and atropine, which of the following is the best treatment for this patient’s presentation? Learn more about this case, take the quiz, and join the conversation on Figure 1. 

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