Point-of-care cardiac ultrasound is increasingly finding use in the diagnosis and management of critically ill patients. Evaluation of cardiac function and the diagnosis of shock states have been thoroughly documented over the years, but one oft-overlooked benefit of cardiac ultrasound may be its ability to simplify the differentiation of certain arrhythmias when electrocardiography is indefinite.

A 66-yr-old male developed tachycardia that appeared to be sinus in nature after a lung transplant for chronic obstructive pulmonary disease. High clinical suspicion for an atrial arrhythmia led to further investigation, as 2:1 atrial flutter can frequently masquerade as sinus tachycardia. Administration of adenosine has been employed frequently to help uncover atrial flutter waves; however, point-of-care cardiac ultrasound and examination of diastolic flow into the left ventricle can also be utilized.2,3  In normal sinus rhythm, pulsed-wave...

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