TY - JOUR T1 - Swinging heart and vector alternans: signs of impending doom JF - Heart JO - Heart SP - 1545 LP - 1545 DO - 10.1136/heartjnl-2013-304058 VL - 99 IS - 20 AU - Lovely Chhabra AU - David H Spodick Y1 - 2013/10/15 UR - http://heart.bmj.com/content/99/20/1545.abstract N2 - An 80-year-old man with history of atrial flutter and tachy-brady syndrome presented to our hospital with dyspnoea and hypotension. Two days prior, he had undergone atrial flutter ablation and permanent pacemaker placement, and was discharged on dabigatran. Physical examination was remarkable for hypotension, tachycardia, elevated jugular venous pressure (JVP) and pulsus paradoxus. 12-lead ECG revealed atrial flutter and QRS electrical alternans … ER -