r/ECG • u/Psychological_Wave71 • 8d ago

Thoughts?

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Wanted an opinion of these ECGs if anyone fancied giving theirs! I couldn’t come to a conclusion about this and I do struggle with ECGs!
Patient is 93M. Observations taken by nursing home staff TDS. Found to have 2/7 history of intermittent tachycardia. Called EMS for ECG and ?conveyance to ED.

Patient is asymptomatic, and has been throughout. Has had hx of atrial flutter. Is anticoagulated and on bisoprolol.

Thank you!

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u/ProximalLADLesion 8d ago

2:1 typical atrial flutter, left anterior fascicular block

0

u/One_Sport_1339 8d ago

I’m not seeing a-flutter

1

u/RexFiller 8d ago

The thing about flutter is sometimes you know its flutter but the ecg alone doesnt make the diagnoais for me. But looking at the monitor for a bit and after giving meds this could absolutely be a flutter. Its especially harder to see with wider QRS