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