86M w/progressive weakness & diarrhea, +new confusion today. | Figure 1

Case Report

86M w/progressive weakness & diarrhea, +new confusion today. A&Ox3 at baseline. EMS note pt to be bradycardic, altered, with low temperature. Pt received 0.5 mg atropine w/o effect. VS abnml on arrival. PMHx Crohn's, remote DVT on warfarin, anemia, CKD, abnml lytes, anasarca. Recent 2-wk hosp stay for Crohn's flare, followed by 2-wk stay for pneumatosis intestinalis, Tx'd w/Abx & steroids, developed AKI & stable pleural effusions, warfarin stopped. D/C'd to SNF on prednisone taper 5 days ago. Img1 arrival EKG, Imgs2&3 priors from 6 wks/2yrs ago, Img4 CT, Img5 labs. EKG analysis? DDx & Tx?

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