Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with palpitations, lightheadedness, and decreased exercise tolerance. ECG confirms atypical atrial flutter (non-cavotricuspid isthmus dependent). Symptoms are [paroxysmal/persistent]. No evidence of acute decompensated heart failure or hemodynamic instability. Denies syncope, chest pain, or dyspnea at rest.
Clinical Examination Findings
Cardiovascular: Irregularly irregular or regular tachycardia noted. S1/S2 present, no murmurs, rubs, or gallops. Peripheral pulses are symmetric. No jugular venous distension. Lungs: Clear to auscultation bilaterally. Extremities: No peripheral edema. Neurological: Non-focal.
Treatment Protocol
1. Rate control initiated with [Beta-blocker/Non-DHP CCB]. 2. Anticoagulation strategy based on CHA2DS2-VASc score. 3. Evaluation for electrical cardioversion vs. antiarrhythmic therapy. 4. Referral for electrophysiology study (EPS) and potential catheter ablation of the atypical circuit.