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Teachable Moment
March 2016

Pseudoatrial Flutter Waves—When a Flutter Is Not a Flutter

Author Affiliations
  • 1University of Missouri School of Medicine, Columbia
  • 2Division of Cardiovascular Medicine, University of Missouri, Columbia
JAMA Intern Med. 2016;176(3):298-299. doi:10.1001/jamainternmed.2015.8315

A 62-year-old woman was admitted to the cardiology service for new-onset atrial flutter diagnosed postoperatively. She had undergone left ulnar release surgery and while in the postanesthesia care unit was noted to have flutter waves on telemetry. Nursing staff reported associated hypotension at that time. The patient was transferred to our emergency department from where she was admitted for new-onset atrial flutter.

The patient’s medical history was significant for chronic obstructive lung disease, obstructive sleep apnea, type II diabetes mellitus, hypertension, hyperlipidemia, and major depressive disorder. The patient denied palpitations or light-headedness in the postoperative period. The patient reported a history of intermittent dizziness and falls over the preceding months. A telemetry strip that prompted the referral is shown in Figure 1.

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