Cardiology Case Report: Fainting and Swollen Leg

History: A woman in her mid-70’s presents to the hospital for a head injury. She wasn’t going to seek care but her neighbor insisted. She was triaged as “tripped and fell taking out the trash yesterday. Hit her head.” However when you ask the right questions you discover she was pulling a heavy trash can uphill and started to feel short of breath then light-headed. She then stumbled and fainted. You also discover that 3 weeks ago her right leg was swollen for a few days then resolved. She denies any palpitations, chest pain, fever, cough or other complaints. She has no significant past medical history.

Exam: Vital signs and physical exam including her legs is normal. A chest x-ray is done and is read out as normal.

An EKG is done:

Computer Read: NSR = 91, LAD, low voltage QRS, Incomplete RBBB, inferior infarct age undetermined, anterolateral infarct age undetermined