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Too fast, too furious

Heart BMJ

Initial assessment with electrocardiography revealed a regular narrow complex tachycardia with 2:1 atrioventricular (AV) relationship, no clear isoelectric baseline and positive P waves in lead V1 consistent with an atrial flutter of left atrial origin with a rapid ventricular rate (~160/min) ( figure 1A ).

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A woman in her 60s with large T-waves. Are they hyperacute, hyperkalemic, or something else?

Dr. Smith's ECG Blog

edits by Meyers A woman in her 60s with a history of chronic atrial fibrillation on Eliquis, ESRD on hemodialysis, type-II diabetes mellitus, prior CVA, hypertension, and hyperlipidemia presented to the emergency department with multiple complaints after missing dialysis. They are flutter waves, and the rhythm is 2:1 atrial flutter.

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Wide Complex Tachycardia -- VT, SVT, or A Fib with RVR? If SVT, is it AVNRT or AVRT?

Dr. Smith's ECG Blog

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia.

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Atrial dilatation in Atrial fibrillation : A query with multiple twists!

Dr. S. Venkatesan MD

A fibrillatory wave that occurs at a rate of more than 600 beats per minute can cause fatigue in the long run, leading to atrial dilation. In all probability, this dilation is a form of atrial tachycardia and atrial cardiomyopathy. We know atrial flutters can be confined to one atrium.

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Physiology Friday #228: Identifying Sleep Patterns that Influence Chronic Disease Risk

Physiologically Speaking

For participants who slept just 5 hours per night, hypertension risk increased by 29%, depression risk increased by 64%, and anxiety risk increased by 46%. One last important finding regarding sleep duration was the J-shaped association between nightly sleep duration and the risk of hypertension, anxiety, and depression.

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What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Dr. Smith's ECG Blog

The rhythm is 2:1 atrial flutter. The flutter waves can conceal or mimic ischemic repolarization findings, but here I don't see any obvious findings of OMI or subendocardial ischemia. Chronic RVH is due to chronic pulmonary hypertension, and these patients are extremely difficult to manage when they are acutely ill.

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Ischemic ST depression maximal in V1-V4 (vs. V5-V6), even if less than 0.1 millivolt, is specific for Occlusion Myocardial Infarction (vs. subendocardial non-occlusive ischemia)

Dr. Smith's ECG Blog

A 50-something man with history only of alcohol abuse and hypertension (not on meds) presented with sudden left chest pain, sharp, radiating down left arm, cramping, that waxes and wanes but never goes completely away. 2 months later, he presented in pulmonary edema with atrial flutter and formal echo had EF 20% Why did this happen?