Case 163: A 78 Year-Old Woman in ER with Palpitations
History
Diagnosis
History
A 78 year old woman with remote history of myocardial infarction presents to the ER with palpitations and persistent heart rate over 100bpm for the last several days.
Diagnosis
- Atrial Flutter with 2:1 AV conduction
- Anteroseptal myocardial infarction
Comment: When 2:1 conduction is present during atrial flutter, it can be very difficult to see the p-waves. The original computer interpretation of this ECG was sinus tachycardia but one can clearly see that there are two p-waves (labeled ‘P’) for each QRS complex.
ECG ID: E809