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Cardiology Case Report: Near Syncope

This cardiology case report from Brady Pregerson, MD, features man in his late-60s presenting to urgent care with 3 days of upper respiratory infection symptoms and one episode of near syncope. Check out the ECG and see if you can determine the correct diagnosis!

History:

A patient in their late-60s with no cardiac history presents to the urgent care with 3 days of upper respiratory infection symptoms and one episode of near syncope today. He denies palpitations, chest pain, SOB, leg swelling, fever or other complaints.

Exam:

Vital signs are normal. The physical exam is normal except for a regularly-irregular rhythm

An ECG is performed:

ECG printout from a patient featured in a case report | Credit: Brady Pregerson, MD

Computer Read: Atrial flutter with variable AV block and RVR at a rate of 145, NSST abnormality.

Other Info: Heart Rate: 148 on the cardiac monitor

Credit: Brady Pregerson, MD

What is the most likely rhythm in this patient?


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