9th Annual UMEM Residency ECG Competition

Welcome to our 9th Annual ECG Competition.  Detailed answers will be explained on our site June 7, 2021 (questions 1-6) and and June 14, 2021 (questions 7-12 + bonus).


Question #1.  This 50 yo M presents with chest pain and has STE in both limb leads and precordial leads.

1a. What is the diagnosis? (1 pt)
1b. What is the basis for your answer in 1a (versus other potential causes of diffuse STE). (2 pts)


Question #2.  A 79 yo M presents after a syncopal episode with this ECG. What is the rhythm diagnosis? (2 pts)


Question #3:  A 74 yo W reports intermittent SOB and nausea all day. This is her ECG. VS: afeb, HR 115, BP 125/65, RR 21, pox 96%, FS 100. Looks ok, lungs clear.

3a. What is the ECG diagnosis? (1 pt)

3b. What is your management for this rhythm? (2 pts)


Question #4:  A 35 yo M presents with agitated delirium. After giving some benzos for sedation, you get this ECG.

4a. What is the drug of choice to treat this condition? (1 pt) 4b. What are 4 ECG findings that will improve with treatment? (2 pts)


Question #5:  A 60 yo W presents with CP and this ECG.  Please provide a FULL ECG interpretation (3 pts)


Question #6:  A 77 yo W presents after a syncopal episode and has this ECG.

6a. What was the probable cardiac rhythm that caused the syncope? (1 pt)
6b. What is the treatment for this patient? (1 pt)


Question #7:  This 31 yo W presents with dyspnea.

7a. What is the cause of the dyspnea? (1 pt)
7b. What are 3 classic ECG findings when this condition gets severe? (1 pts)


Question #8:  This 85 yo M presented with palpitations.  What is the FULL ECG diagnosis? (2 pts)


Question #9:  An 85 yo M awaiting admission for GI problems had a telemetry alarm go off transiently, and the nurse printed this 12-lead from the event. He is currently back in sinus rhythm and doing fine. What is your management after reviewing this ECG? (2 pts)


Question #10:  A 71 yo M presents after a syncopal episode. This is his ECG. What is the FULL ECG diagnosis? (3 pts)


Question #11: A 49 yo M presents with malaise, chest pressure, dyspnea, and nausea. BP 85/40.

11a. What is the diagnosis? (1 pt)
11b. Name two other conditions that, when severe, can produce STE in V1 + V2 + aVR, with RAD (2 pts)
11c. Explain why this condition can produce a Brugada pattern in V1-V2 (1 pt)


Question#12: You just got sign-out on a 40 yo W with intractable nausea/vomiting and chest pain presumably due to cannabis-related hyperemesis + gastritis. Labs ok, but no EKG was done. The nurse brings you this rhythm strip which was just pulled up from the monitor.

12a. What’s the diagnosis? (2 pts)
12b. What medication is best, specifically for this rhythm? (1 pt) 12c. Explain your answer to 12b. (1 pt)


Question#13:  BONUS: This is a 61 yo M with nausea, malaise, lightheadedness, and palpitations all day. He presents with this ECG. His first TN-I is negative.

13a. What is the likely dx?
13b. List as many causes of STE as you can think of

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