Most Ignored ECG Lead, aVR can be Lifesaver! “Short of Breath in Seattle!”

As if to rhyme with the famous Hollywood movie titled, 'Sleepless in Seattle', I saw a 64-year old man in my office in cardiac consultation who after having dinner with his son and daughter-in-law in Seattle was extremely short of breath while walking up a few stairs to his hotel room. He is from upstate New York area and was visiting them in Seattle. He never had any symptoms like this before. He did have some chest discomfort at the time but the shortness of breath was quite concerning to him. He did not have palpitations, dizziness, diaphoresis or syncope. He did not seek any medical help in Seattle and made an appointment to visit his primary care physician upon return to Upstate, NY. He was then requested to come and see me the next day. This event of shortness of breath in Seattle took place a month before coming to see me.