History:
This ECG was recorded from a 56 year-old man who developed acute onset of SOB while he was having lunch in the ward. He has a history of rheumatic fever as a child. Currently on treatment for hypertension and gout.
ECG shows:
Atrial fibrillation:
-irregular ventricular response, rate ~60/min
-no obvious saw-tooth pattern in inferior leads (best place to look for atrial flutter)
-fibrillation waves in rhythm strip which resembles flutter waves (In Atrial flutter, you should be able to see flutter waves in most leads)
Normal axis, QRS duration, QT for rate
Non specific ST segment changes in lateral leads.
PVC
This patient had SBE, echocardiogram confirmed vegetations on mitral leaflets with moderate MVR, also mild TVR and moderate aortic stenosis.
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