Atrial Flutter Chest Pain Dysrhythmia 
Dr. Smith's ECG Blog
OCTOBER 25, 2022
She reports that she is now unable to vagal out of her palpitations and is having shortness of breath and dull chest pain. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. Her initial EKG is below. Smith: should we give adenosine again?
Dr. Smith's ECG Blog
JANUARY 5, 2020
This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain. Atrial dysrhythmias, and atrial fi brillation in particular, are frequently misdiagnosed by computer algorithms and then by the physician who overreads them. The patient in this case presented with dyspnea and chest pain.
Dr. Smith's ECG Blog
MARCH 6, 2020
This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea. There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm. The other atrial flutter types are: 1.
Dr. Smith's ECG Blog
APRIL 8, 2015
Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade.
Dr. Smith's ECG Blog
MARCH 6, 2025
Sinus tach is often misinterpreted as a dysrhythmia. Possible but, again, the QRS morphology is atypical 3) Atrial Flutter with 2:1 conduction and "aberrancy". I do not see flutter wave baseline, and again the QRS morphology is not typical for a supraventricular rhythm. 2) PSVT with "aberrancy" (atypical RBBB+LAFB).
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