Introduction

Atrial flutter defined as fast heart beat that results from a rapid electrical circuit in the atrium.
Atrial flutter can be caused by scarring in the heart resulting from prior cardiac disease or heart
surgery, but it can also occur in some patients with no other identifiable heart problems.

The process of Atrial flutter starts from electrical activity begins in a large circuit that causes the
atria to beat very rapidly. The rapid beating of the atria can in turn cause the ventricles to beat
rapidly. Studies from the Marshfield Epidemiologic reported the incidence of atrial flutter in
those younger than 50 years is 5/100 000. The classification by Puech and Grolleau described
two types of Atrial Flutter i.e., type ‘common’ – predominantly negative biphasic flutter waves
were seen in inferior leads with a sawtooth pattern, which preceded the positivity in V1 and type
‘rare’ or ‘atypical’ – if the ECG morphology was different from the common type. Atrial flutter
can increase risk of a stroke, important to determine when the symptoms started which can lead
to decrease morbidity.

Case Ilustration

A 35-year-old male, come to RSUD Tais with complaints of high fever since 5 days before
admission.

He complained of shivering with nausea, vomiting, decreased appetite, epigastrium pain, joint
pain. .

Since 2 day before admission he complained of stool liquid 5-7 times/day.

Since 1 day before admission he admitted complaint is getting worse with palpitation and
malaise.

On admission, he admitted increased palpitation. He has not hypertension, diabetes mellitus,

history of smoking, heart disease, cardiac surgery or catheter ablation.

From physical examination there are increasing of temperature and bowel sound. Epigastrium
tenderness is positive with VAS 6. The other physical exam within normal limit.

From laboratory examination and abdominal USG within normal limit.

From ECG there is saw teeth pattern as the character for atrial flutter.

From echocardigraphy shows hypokinetic at medial region

Discussion

Patients do not come because of complaints that lead to symptoms of atrial flutter. In these
patients there were no risk factors for coronary heart disease. There are a number of non-specific
symptoms that lead to the possibility of heart contraction disorders, which are chest palpitations
and weakness. Oriented to the chief complaint, non-specific cardiac symptoms are often
overlooked, so it is rarely performed for a heart-related examination.

Conclusion

The importance of identifying patient health problems comprehensively and in detail so that a
doctor does not miss important things that are rarely found, such as the case of atrial flutter in
young populations is very dangerous for patients.