Patient presents with symptoms suggestive of typical atrial flutter, including palpitations, shortness of breath, and occasional lightheadedness.  Electrocardiogram (ECG, EKG) reveals a sawtooth pattern characteristic of atrial flutter with a regular atrial rate of approximately 300 beats per minute and a ventricular rate controlled between 70-150 beats per minute, consistent with a 2:1, 3:1, or 4:1 atrioventricular (AV) conduction.  No evidence of pre-excitation or accessory pathways observed.  Symptoms onset reported two days prior to presentation, with no clear precipitating factors identified.  Patient denies chest pain, syncope, or history of atrial fibrillation or flutter.  Medical history significant for hypertension, well-controlled with lisinopril.  Physical examination reveals stable vital signs with regular pulse, though rapid.  Lungs clear to auscultation.  No peripheral edema noted.  Assessment:  Typical atrial flutter, likely of recent onset.  Plan:  Initiate rate control with metoprolol.  Consider anticoagulation with warfarin or a direct oral anticoagulant (DOAC) such as apixaban or rivaroxaban after assessment of CHA2DS2-VASc score for stroke risk stratification.  Refer to cardiology for electrophysiology consultation and consideration for cardioversion or ablation therapy.  Patient education provided on medication management, potential complications, and follow-up care.  ICD-10 code I48.4 specified.