This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: AIIMS 2018, Subject name: Medicine
A smoker presents with recent onset breathlessness and ECG was done. The diagnosis is? 
Select and explain. 
A. Atrial fibrillation, B. Paroxysmal supraventricular tachycardia, C. Acute myocardial infarction, D. Multi-focal atrial tachycardia
D: Multi-focal atrial tachycardia
Answer: D: Multi-focal atrial tachycardia 
Explanation: Multi - focal Atrial tachycardia: - Irregular R-R internal - Right axis detion - Variable amplitude P-wave - Normal PR interval - Non progression of R-wave (suggestive of Right ventricular etiology Atrial fibrillation Irregular R-R intervals and absence of P waves. AF Ruled out because these is P wave present in ECG. Acute myocardial infarction No STEMI No T wave inversion PSVT ruled out - Rhythm normal