Absent P Waves & Murmur

29 yr old female with absent P waves on 12 Lead ECG otherwise normal QRS complex Pulse varying usually 63 -73 BPM, BP 120/80 Thymectomy 10months ago, with no abnormal ECG which was done Pre OP, weakened radial pulses (could be also with other pulse sites) within 1 min pulse will be strong & consistent then for about 15 seconds it becomes very weak almost unnoticeable and then it picks up again, also mention of a heart murmur, Whats going on, confused how someone can have a normal ECG 10mths ago and now not have P Waves & Murmur. No severe dizziness every now and then feeling light headed, some periods of varying time SOB,

Thank You

[itdood]

I'm going to guess hyperkalemia (too much potassium in your blood).

The angle of the picture makes it tough to see your EKG.  I thought I could make out a P wave before all your QRST waves, but they are tiny.

A small or absent P wave with other intervals looking good could be from hyperkalemia.   It's the only thing I could find that fit a differential diag with that EKG.  Other diag for absent p-waves is afib or flutter and you definitely do not have that going on.

Your R-R interval looks good, it's a regular rhythm.  The QRS complexes aren't too wide or too narrow, they're in range.  That's about all I could read from the photo.

The regruge (murmur) might be related, I can't really say.  I would treat the obvious and go from there.

Are you taking any meds that might be making your potassium levels too high?