What do y'all think of this EKG? Healthy, 40 year old male with Covid + in May, recovered, since then has had intermittent fluttering and has Hx or chronic Migraine.
Paroxysmal Atrial Tachycardia versus 2:1 Atrial Fluttler?
given our incomplete understanding of COVID I'd be a bit cautious.
tachycardia and inferior TWI (or biphasic) -- has he got RV strain?
a TTE would be good
Looks like sinus tachycardia to me, but I'd be interested if he's a steady 120 or has variability. Also if you're really unsure you can just give some adenosine and try to slow down the AV node to unveil flutter waves.
V1 P wave morphology is important
" Typical Atrial Flutter (Common, or Type I Atrial Flutter)
Involves the IVC & tricuspid isthmus in the reentry circuit. Can be further classified based on the direction of the reentry circuit (anticlockwise or clockwise):
Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces:
Inverted flutter waves in leads II,III, aVF
Positive flutter waves in V1 – may resemble upright P waves
Clockwise Reentry. This uncommon variant produces the opposite pattern:
Im leaning towards sinus tach and the problem is not in the T waves. P waves seem P wave pulmonale in some leads. I have seen this a bunch of times in CoViD patients.
Eg. Hypoxic pulm vasoconstriction, increased PA pressures etc etc
OR
Needs of diuretics
#my2cents
This site uses cookies to help personalize content, tailor your experience and to keep you logged in if you register.
By continuing to use this site, you are consenting to our use of cookies and terms of service.