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Challenges in Clinical Electrocardiography
January 2018

A Rapid Irregular Rhythm in a Healthy, Young Patient: How Fast Can You Go?

Author Affiliations
  • 1Department of Medicine, University of California San Francisco, San Francisco
  • 2Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco
  • 3Division of Cardiology, Department of Medicine, San Francisco General Hospital, San Francisco, California
JAMA Intern Med. 2018;178(1):138-140. doi:10.1001/jamainternmed.2017.7030

A healthy woman in her 20s presented to the emergency department with palpitations after completing a run. On presentation, her blood pressure was 125/80 mm Hg, heart rate was approximately 200 beats per minute (bpm), and oxygen saturation was normal on room air. Cardiac examination was notable for a normal jugular venous pressure with absence of a prominent A wave, a tachycardic and irregular rhythm, normal apical impulse, normal heart sounds, and no murmurs, rubs, or gallops. Physical examination results were otherwise unremarkable.

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