Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 42
Electrocardiographic Report
Irregular cardiac rhythm with combined rheumatic mitral
stenosis and aortic stenosis
D. Luke Glancy, MD, and T. Griffin Gaines, MD
Figure. Electrocardiogram in a 56-year-old man. See text for explication.
n electrocardiogram in a 56-year-old man revealed
coarse atrial fibrillation with a controlled ventricular
response, a single ventricular premature complex, left
ventricular hypertrophy, and digitalis effect (Figure).
The fibrillatory waves are large and superficially resemble atrial
flutter, but unlike flutter waves, the waves are not uniform in
voltage or timing. Coarse atrial fibrillatory waves, i.e., those
with an amplitude >1 mm (0.1 mV), are more often associated
A
40
with rheumatic valvular disease (1), congenital heart disease
(2), or hypertrophic cardiomyopathy, whereas fine fibrillatory
From the Sections of Cardiology, Departments of Medicine, Louisiana State
University Health Sciences Center and the Interim Louisiana State University
Public Hospital, New Orleans.
Corresponding author: D. Luke Glancy, MD, 7300 Lakeshore Drive, #30, New
Orleans, LA 70124 (e-mail: [email protected]).
Proc (Bayl Univ Med Cent) 2014;27(1):40–41