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Challenges in Clinical Electrocardiography
February 13, 2017

Abnormal Electrocardiogram in a Woman With Atrial Fibrillation and Recent Care Transition

Author Affiliations
  • 1Internal Medicine Residency, University of California San Francisco, San Francisco
  • 2Zuckerberg San Francisco General Hospital, Division of Cardiology, University of California San Francisco, San Francisco
JAMA Intern Med. Published online February 13, 2017. doi:10.1001/jamainternmed.2016.9356

A woman in her 80s with a history of severe symptomatic aortic stenosis and recent transfemoral transcatheter aortic valve replacement (TAVR) presented with a change in mental status characterized by lethargy, blurred vision, nausea, and diarrhea. Her other comorbidities included persistent (chronic) atrial fibrillation (AF), moderate mitral stenosis (peak and mean transvalvular gradients of 12 mm Hg and 5 mm Hg, respectively, with valve area 1.4 cm2) and left intraventricular conduction delay.

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