Atrial Flutter on Neck Examination



If you can dx this rhythm, you are born before 1960. 

Early on the clip, one sees a venous pulse of 140, being the "c" wave. On inspiration, increased venous return accentuated the "a" wave, revealing the flutter waves at double the ventricular rate. Hence 2:1 flutter.

AVNRT would show a single large “a/c” wave as A and V contract simultaneously. It would look like a constant cannon a wave.  In this Pt we see flutter waves on inspiration. 



James Ong, MD @JamesOngMD



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