Figure 1.

The patient is a 42-year-old man with a sensation he describes as his heart “flipping” intermittently for the last 3 days. He denies chest pain, shortness of breath, diaphoresis, or dizziness.

Upon exam, you find:

General: Alert and oriented X 3, sitting comfortably in a chair

Lungs: CTAB

Cardiovascular: RRR without murmur, rub, or gallop

Abdomen: Soft and NT

View the ECG taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

A 42-Year-Old Man with a ‘Flipping’ Sensation in his Heart