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What Do You Think 11

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What Do You Think 11

Author

Assoc Prof Harry Mond

Published

February 23, 2026

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32-year old elephant trainer with flat feet.

Clue: sinus rhythm with 12-lead ECG, but P waves hard to see.  

What do you think?

 

It isn’t hard.

Again dissect it down to its basics.

  • Sinus rhythm 60 bpm (red vertical arrows). Yes 60 bpm!
  • Alternate beats are premature; bigeminy.
  • Interpolated atrial ectopics (red highlight).
  • Some ectopics are conducted with aberration(yellow highlight).

Sinus rhythm with bigeminal interpolated atrial ectopics and aberration

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