case_images: PMC7218462_01
case_images: The patient's electrocardiogram in which the red arrows indicate the typical flutter waves (f-waves) that occur right before the QRS complex, simulating a pseudo-preexcitation pattern. The segment underscored in black indicates the f-waves in series at a rate of approximately 240 beats per minute. The QRS complexes are occurring at 120 to 140 beats per minute, hence the 2:1 atrioventricular block.
case_images: 10.1177_2324709620925571-fig1.jpg
case_images: PMC7218462_01_10.1177_2324709620925571-fig1.jpg
case_images: fig1-2324709620925571
case_images: The patient's chest radiograph does not indicate any airspace disease that would be expected in coronavirus-2019 (COVID-19) infection.
case_images: 10.1177_2324709620925571-fig2.jpg
case_images: PMC7218462_01_10.1177_2324709620925571-fig2.jpg
case_images: fig2-2324709620925571
case_images: A chest radiograph did not reveal any acute cardiopulmonary disease (see Figure 2), while a bedside 2-dimensional transthoracic echocardiogram demonstrated a preserved left ventricular ejection fraction, without any regional wall motion abnormalities.
case_images: The patient's rhythm strip post-cardioversion, which indicates coarse atrial fibrillation with a rapid ventricular response. The variable RR intervals highlighted by the interspersed red lines.
case_images: 10.1177_2324709620925571-fig3.jpg
case_images: PMC7218462_01_10.1177_2324709620925571-fig3.jpg
case_images: fig3-2324709620925571
case_images: Despite these therapies, the patient unsuccessfully underwent cardioversion with 100 J and subsequently transitioned to atrial fibrillation with rapid ventricular (AF RVR) response (see Figure 3).