Review Question - QID 214188

A 17-year-old boy presents to the emergency department after losing consciousness at a baseball game. The patient was hit in the chest with a baseball that was pitched at him. He immediately lost consciousness, and a paramedic on scene connected the patient to a monitor and obtained the rhythm strip seen in Figure A. CPR was initiated, and the patient was defibrillated with a prompt return of pulses. The patient was then transported to the emergency department. The patient has a past medical history of type I diabetes and a 2 pack-year smoking history and is poorly compliant with his medications. In the emergency department, the patient is in sinus rhythm. A chest radiograph is seen in Figure B. Basic labs are pending, and a fingerstick blood glucose is noted to be 254 mg/dL. Which of the following is the most likely etiology of this patient's symptoms?