Monday, November 7, 2011


A 70 year-old patient is referred to neurology clinic, and before meeting the patient, you review the chart. This EKG stands out to you. Initially, you think it's one rhythm, but then you take a look at every single lead.

Challenge: What is the patient referred to you for?

Image shown under Fair Use.


Anonymous said...

parkinson's disease

Craig Chen said...

exactly right!

The case is called earthquake because this is a tremor. Although it initially appears to be atrial flutter, when you examine V2 and V3, you can see a clear P wave, suggesting that this rhythm is sinus with a superimposed tremor.

Source: ECG Wave Maven (