A 70-year old hypeensive patient with a complaint of palpitations and pre-syncope. On examination, his hea rate is 72 BPM and BP was 150/100. ECG performed shows?: (A) Atrial flutter, (B) Atrial fibrillation, (C) Multifocal atrial tachycardia, (D) PSVT
Answer is A. ECG in lead II and other inferior leads shows the presence of flutter waves( Saw tooth pattern). 3-4 flutter waves before every narrow QRS complex. Since the ventricular rate is 75 bpm (RR interval), atrial rate shall be obtained by multiplying the ventricular rate by 4 which is 300 bpm The presence of risk factor of hypeension also give clue to diagnosis of atrial flutter.