Chest pain with syncope

An 85-year-old woman, with a medical history of hypertension and atrial fibrillation (AF), which was treated with apixaban, bisoprolol, and furosemide, came to the emergency department with complaints of atypical chest pain and a syncopal event at home. It was one of the coldest days of the year, and the patient had a tympanic temperature of 34˚C at admission. While awaiting medical observation, the patient had a new syncopal event with quick recovery. She was brought to the resuscitation room where electrocardiography (ECG) was performed (Figure 1A). The previous ECG, taken 2 months before, is also shown (Figure 1B)