![]() ![]() Her electrocardiogram showed bradycardic heart rate (41/min), right bundle branch block and 2:1 atrioventricular (AV) block ( Figure 1). Neurological examination was unremarkable. Other system examinations revealed no abnormalities. A cardiac examination revealed prosthetic aortic valve sound and 2/6 systolic murmur. On physical examination, the patient with an ongoing dizziness had blood pressure of 120/75 mmHg, heart rate of 41/min and body temperature of 36.6☌. In addition, she was receiving warfarin for AVR. The patient reported to have been receiving irbesartan (150 mg)+hydrochlorothiazide (12.5 mg) and amlodipine 10 mg for hypertension. ![]() ![]() She reported to have no other chronic diseases but hypertension for 15 years. The patient had undergone aortic valve replacement (AVR) due to calcific aortic valve stenosis 10 years ago. A 79-year old female patient was admitted to the emergency service with a 10-day history of complaints of dizziness, nausea, loss of appetite and syncope on the day of admission. ![]()
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