Thursday, August 1, 2019

Atrial flutter 3:1 misdiagnosed as complete heart block




60 y.o. female who presents from her group home for evaluation. Patient has been noted to be increasingly weak and lethargic over the past 2 days. Reportedly had an episode of hypotension prior to arrival. Patient is hesitant to answer questions on arrival. States she just feels generally weak. She denies acute pain. She denies shortness of breath. She denies nausea. 



Can't find any meds that would make the flutter so slow

not on anticoagulants

On aspirin


Dig level 0.4 ng/mL (0.5-2.0)

K = 2.7 mEq/L
K = 2.7



After K replacement








Case 2.

I am uncertain of this patient's symptoms, but I imagine he was weak:
What is this?














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