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Challenges in Clinical Electrocardiography
October 2015

A Case of P-Wave Mimicry: Cherchez le P

Author Affiliations
  • 1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida
  • 2Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, Jacksonville, Florida
  • 3Division of Cardiology, Department of Medicine, San Francisco General Hospital
  • 4Department of Medicine, University of California–San Francisco
JAMA Intern Med. 2015;175(10):1693-1694. doi:10.1001/jamainternmed.2015.3342

A man in his 60s presented to the emergency department with chest pain. He had a history of hypertension but no other cardiac history. His pain was described as a dull ache localized to his epigastrium; it had been constant for 4 hours, did not radiate, and was not exacerbated by exertion. Examination of the heart, lungs, and abdomen had normal results. A chest x-ray revealed no acute cardiopulmonary process. An electrocardiogram (ECG) was obtained and is shown in Figure 1.