A young man is brought by ambulance to the ED in Connecticut after recurrent episodes of shortness of breath, palpitations, fatigue, and syncope; a rhythm strip was acquired en route. The patient describes his palpitations as spontaneous, irregular forceful beats, with a sensation of a racing heart. The cardiac examination reveals an irregular, tachycardic rhythm. Multiple, bilateral macular erythematous lesions with large central pallor are noted on his thighs.

HINT
The patient's rash and geographic location are of particular importance


What is the underlying etiology?

the ecg appear av dissociation most likely to be due to myocarditis or mi due to that erthematous rash bilateral
but whn i see to ecg there is no mi
الحصيل ايش الكوس قولونا لكن الاي سي جي الاول في الي قتللك عليها

اصبر اشوي يارجل ..كنك انت