What’s the Diagnosis #15

An elderly patient presents with leg weakness over the prior two days. The day of presentation he also notices pain in his upper back which seems to be fairly persistent. His medical history includes diabetes and renal failure. He was dialyzed the afternoon prior to his presentation and his glucose was 264. The patient’s daughter stated that he “wasn’t acting himself.” The patient’s physical exam was fairly normal. Perhaps a little weakness in his legs, but he still moved all extremities. His current EKG (dark background) and another EKG faxed from a different hospital done six months earlier (light background) are shown below. You can click on them for larger images. What’s the diagnosis and what’s the next step? I’ll post the answer underneath the EKGs in a couple of days.
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: Tags: What's the Diagnosis? Source Type: blogs