A 75-year-old man with known chronic obstructive pulmonary disease resulting from a long history of cigarette smoking presents to the emergency room with a 2-day history of worsened shortness of breath and a cough productive of yellowish sputum. He is afebrile. His blood pressure is 120/70 mm Hg and pulse rate is 150 bpm. Lung examination is remarkable for diffuse rhonchi and expiratory wheezes. An ECG is obtained.
His chest x-ray is consistent with chronic obstructive pulmonary disease, but no infiltrates are present. It is felt that he has chronic obstructive pulmonary disease exacerbation and bronchitis and is begun on antibiotics and a steroid taper. ECG A was obtained in the emergency room. ECG B was obtained 2 days later after improvement in his respiratory status was seen.
What is the diagnosis?
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