Review Question - QID 109435

A 67-year-old man presents to the emergency department with sudden fatigue and an episode of syncope. His symptoms came on suddenly while he was doing laundry. After the episode, the patient continued to feel generally weak and dizzy and felt fatigued. The patient's wife brought him into the emergency department. The patient denies any medical history and is not currently taking any medications. He has not seen a physician since he came to the U.S. 5 years ago. His temperature is 99.5°F (37.5°C), blood pressure is 100/72 mmHg, pulse is 140/min, respirations are 14/min, and oxygen saturation is 96% on room air. An ECG is ordered and is seen in Figure A. The patient is started on IV fluids and metoprolol. A physical exam is performed and is notable for a lean body habitus and poor hygiene. A pulmonary exam demonstrates minor crackles and a cardiac exam demonstrates a diastolic rumbling heard at the cardiac apex. The patient's neurological exam is within normal limits. Which of the following would most likely be found in this patient's history?