Core
Results:
Modified Sgarbossa Criteria: STEMI Equivalent Pattern
Key Points: LBBB and ventricular-paced rhythms can hide acute coronary occlusion because abnormal depolarization creates expected secondary ST-T changes. Occlusion MI can still be recognized when those ST changes are…
Preexcitation Syndromes: Overview
Key Points: Pre-excitation means an accessory pathway allows atrial impulses to reach the ventricle without traversing the AV node, producing early ventricular activation. A delta wave is the defining ECG…
Wolff-Parkinson White (WPW) Syndrome
Key Points: Pattern vs syndrome: WPW pattern is ECG evidence of pre-excitation without symptoms. WPW syndrome is pattern plus symptomatic tachyarrhythmia (palpitations, syncope, “seizure”, aborted sudden cardiac arrest). PR interval…
Atrial Flutter 1:1 Conduction
Key Points: Rare, high-risk rhythm. 1:1 flutter can drive ventricular rates into the 240–320 bpm range and can rapidly cause hypotension, ischemia, or collapse. It often mimics VT. Ask “how…
WPW Syndrome and Pseudo-MI Patterns
Key Points: WPW alters ventricular depolarization, producing secondary repolarization abnormalities that can mimic or mask myocardial infarction. ST-segment deviation in WPW is often non-ischemic, driven by abnormal activation via the…
Atrial Fibrillation with WPW (Pre-excited AF)
Key Points: Pre-excited AF is the most dangerous WPW rhythm. It can deteriorate quickly to VF because the accessory pathway may conduct atrial impulses to the ventricle at extreme rates….
WPW with Antidromic SVT (Antidromic AVRT)
Key Points: Antidromic AVRT is an AV re-entrant tachycardia that conducts antegrade down the accessory pathway and returns retrograde through the AV node (or another pathway), producing a regular wide-complex…
WPW with Orthodromic SVT (Orthodromic AVRT)
Key Points: Orthodromic AVRT is the most common tachyarrhythmia in WPW and presents as a regular narrow-complex SVT that is indistinguishable from AVNRT during the tachycardia. Mechanism: antegrade conduction down…
The Life Savers: Critical ECG Pattern Hub
Key Points: Critical ECG patterns represent time-sensitive, life-threatening cardiac or systemic conditions that demand immediate recognition to prevent death or irreversible organ injury. These are the “can’t-miss” ECGs. Use this…
Stepwise Approach to STAT ECGs Hub
Key Points: Consistency saves lives: Use a repeatable ECG routine to reduce misses in chaotic settings. Many valid methods exist. Pick an order that fits your acute-care workflow and do…
ECG Foundations: Vectors, Leads, & Activation
Key Points: An ECG records voltage differences over time. The ECG tracing is a plot where the horizontal axis is time and the vertical axis is voltage. Leads are viewpoints….
ECG Basics & Fundamentals Hub
Key Points: This hub organizes the core ECG basics and fundamentals into three complementary “start here” pathways: ECG definitions and measurement, how ECGs are generated and work, and the acute…
Third-Degree AV Block (Complete Heart Block)
Key Points: Definition: Third-degree AV block is complete failure of conduction from atria to ventricles, resulting in independent atrial and ventricular activity—known as AV dissociation. Hallmark Feature: No P waves…
Second-Degree AV Block Type I (Mobitz I/Wenckebach)
Key Points: Definition: Progressive PR interval prolongation until one atrial impulse fails to conduct to the ventricles (P wave is non-conducted), after which the cycle repeats. Site of Block: Typically…
Second-Degree AV Block with 2:1 Conduction
Key Points: Definition: A form of second-degree AV block in which every other atrial impulse is blocked, producing a 2:1 atrioventricular conduction ratio. Typing Limitation: Differentiating between Mobitz I and…
High-Grade (Advanced) AV Block
Key Points: Definition: A severe form of second-degree AV block with two or more consecutive non‑conducted P waves (for example 3:1, 4:1). Do not force a Mobitz label when multiple…
Bidirectional Ventricular Tachycardia (BiVT)
Key Points: BiVT is a regular wide-complex tachycardia with strict beat-to-beat alternation of QRS axis and/or bundle-branch pattern (often an approximately 180° frontal-plane axis flip). In adults, assume digoxin toxicity…
Occlusion MI: STEMI Criteria & Beyond
Key Points: The ECG’s primary role in ACS is detecting acute coronary occlusion. Acute coronary occlusion myocardial infarction (OMI) is a time-critical diagnosis that requires immediate reperfusion. Time is myocardium….
STEMI (-) Occlusion MI: OMI Patterns
Key Points: Traditional STEMI criteria miss many acute coronary occlusions. A substantial proportion of true OMIs do not meet classic millimetric STEMI thresholds. OMI is a pathophysiologic diagnosis, not an…
QT Interval: Basics
Key Points: Definition: QT is measured from QRS onset to T-wave end. It reflects total ventricular depolarization plus repolarization. Use QTc: QT varies with heart rate. Interpret QTc, not the…
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