A 74-year-old man with hypertension presented to the emergency department after a syncopal episode. His pulse rate was 55 beats/min and other vital signs were normal. Physical examination result was normal. His ECG was initially interpreted as having a 2-second sinus pause (Figure). Cardiac troponin and electrolyte levels were normal. The emergency physician performed point-of-care ultrasonography to assess the relationship between atrial and ventricular contractions (Video).
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