CC BY-NC-ND 4.0 · Indian J Cardiovasc Dis Women WINCARS 2021; 06(04): 250-251
DOI: 10.1055/s-0041-1739128
Images in Cardiology

Himalayan Fibrillatory Waves in Juvenile Rheumatic Mitral Stenosis

Mohamed Kassim Akheela
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
A. Shaheer Ahmed
2   Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
› Author Affiliations


An 18-year-old girl, a known case of rheumatic mitral stenosis, presented with dyspnea and palpitations. Electrocardiogram was done, which revealed atrial fibrillation and a large amplitude atrial fibrillatory wave, which was more than the voltage of R wave V1, a finding which is quite uncommon. Echocardiography revealed a large left atrium which was 80 mm in diameter. The patient was started on oral anticoagulation and referred for mitral valve replacement with maze procedure.

Publication History

Article published online:
14 December 2021

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