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They thought it was sinus tachycardia. Until her heart rate refused to budge, and she passed out in front of us. 47-year-old woman. Panic attacks, they said. Tachycardic. Regular rhythm. No chest pain, no fever. The nurse gave a beta-blocker. She collapsed. The ECG? Clean P waves? No. Zoom in. Those aren’t P waves. That’s a sawtooth. That’s atrial flutter. Rhythm regular. QRS narrow. Still think it’s sinus? Atrial flutter is the sneakiest rhythm on the ECG It mimics sinus Mimics SVT Even mimics
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