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Challenges in Clinical Electrocardiography
October 5, 2020

A Man With a Sixth Wave in Electrocardiogram Results

Author Affiliations
  • 1Department of Medicine, Sir Syed College of Medical Sciences, Karachi, Pakistan
  • 2Department of Medicine, Aga Khan University Karachi, Karachi, Pakistan
  • 3Department of Medicine, The Alabama College of Osteopathic Medicine, Gulf Coast Medical Center, Panama City, Florida
  • 4Department of Medicine, Alabama College of Osteopathic Medicine, Dothan
JAMA Intern Med. Published online October 5, 2020. doi:10.1001/jamainternmed.2020.4783

A 39-year-old man presented to the emergency department with a short (few days) history of subjective fever, lethargy, cough, nausea, and vomiting. He had no other medical history, and he denied chest pain or palpitations but complained of generalized weakness. His vital signs on arrival were (1) heart rate, 91 beats per minute (bpm); (2) temperature, 99.6 °F; and (3) blood pressure, 113/73 mm Hg. Based on initial electrocardiogram (ECG) results (Figure, A), an urgent cardiology consultation was requested for atrial flutter.

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