The medical clinical case this week is a 55 year old comes in for episodes of regular and rapid heartbeats, upset at the neck associated with mild dyspnea, diaphoresis and cool skin. These episodes have duration of 20 to 40 minutes, with a frequency of 1 to 2 weeks. He has a history of significant hypertension for 14 years of diagnosis. Physical examination revealed hemodynamic stability, heart rate of 77 bpm, oxygen sat 98%. Cardiovascular examination with rhythmic heart sounds, no S3 or S4, no murmurs. Rest without relevant findings.
During the medical consultation, the family keeps an ECG that was taken in an episode of palpitations in a clinic closer to home. The line is of poor quality and is poorly preserved, but its diagnostic value includes it here:
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By Oscar Millan-Iturbe MD/MPH