A 38-year-old woman after physical overexertion suddenly developed palpitations, dyspnea, and a dull pain in the cardiac area. For 10 years she has been registered for regular check-ups due to rheumatism and mitral valve disease with non-disturbed blood circulation. Objectively her pulse is 96/min., of unequal strength. Blood pressure is 110/70 mm Hg, heart rate is 120/min. ECG registers small unevenly-sized waves in place of P-waves, R-R intervals are of unequal length. What is the most likely diagnosis?

Answer options

1. Atrial fibrillation
2. Paroxysmal ventricular tachycardia
3. Atrial flutter
4. Paroxysmal supraventricular tachycardia
5. Respiratory arrhythmia

Explanation

Characteristic findings in Atrial fibrillation are the absence of P waves, with disorganized electrical activity in their place, and irregular R–R intervals due to irregular conduction of impulses to the ventricles. At very fast heart rates, atrial fibrillation may look more regular, which may make it more difficult to separate from other supraventricular tachycardias or ventricular tachycardia. High blood pressure and valvular heart disease are the most common alterable risk factors for AF.