Case 1 – ECG

Thanks for sending in some interesting ECGs.

This is the first post for hopefully a series of cases where you can all share your learning with others.

This is an ECG Georgia and Amanda sent in.


ecg001 (PDF)

Georgia wrote
“53yoF, self-presented to GP for dizzy spells and lethargy.
Palpated HR 60bpm, irregular with long pauses between beats.
No chest pain or SOB, asymptomatic with crew.
Pt has had non-productive cough for 4 days, afebrile, lungs clear. “
The app thinks it’s either AF or Sinus Tachycardia.
Do you agree, or what is your ECG interpretation?

Thanks Georgia for taking time to share your case with us : )



2 Comments Add yours

  1. Tatsu Kuwasaki says:

    OK, this is the first one so I’m just gonna put my understanding here and hope some of you can further add to it.

    Well, many of you may know that I’m a big fan of Dr Amal Mattu so I interpreted this ECG using his method.

    Three narrow complex irregular tachycardia that we should consider are;
    1. AF
    2. A/Flutter with variable ventricular response
    3. MAT (Multifocal Atrial Tachycardia)

    I’m picking this is A/Flutter because;
    HR 150 ± 20 bpm is very typical for 2:1 flutter
    While there are may not be typical “Saw Tooth Pattern”, I’m reasonably confident that I can map out the P-waves beating at approx 300 bpm.

    Dr Mattu also teaches that ” To see the saw tooth pattern, flipping the ECG upside down and paying attention to all 12 leads will help you identify subtle flutter waves”
    P-waves are also often found easier on V1.

    Please let us know if you have more tips and ideas to help interpret this ECG : )


  2. Tatsu Kuwasaki says:

    One vote for A Flutter by Chris. Any other takers?


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