Lancisi's Sign (Tricuspid Regurgitation) in a patient with Atrial Fibrillation



If you went to med school before I did, you can dx the rhythm and name the lesion :)

One clue: Pt has a PM. 

Everyone sees the obscenely huge waves. But is it giant A or V wave? While it’d be nice to have ur finger on the pts carotid pulse to be sure, can you see the carotid pulse in the clip ?

This is indeed Lancisi's sign. Pt has permanent AF, severe TR, and a PM. The irregularity of HB is c/w AF, with occasional regularization due to VVI pacing.



James Ong, MD @JamesOngMD



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