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Results:
ECG Hallucinations: When S1Q3T3 Misleads
A 51-year-old truck driver presents to the ED after a brief syncopal episode at a rest stop. It is the middle of summer, his truck’s air conditioning is not working,…
S1Q3T3 Pattern
Key Points: Not a PE diagnosis: S1Q3T3 is classically associated with pulmonary embolism, but it is neither sensitive nor specific enough to diagnose or exclude PE. Think acute right heart…
ECG in Pulmonary Embolism (PE)
Key Points: The ECG cannot rule in or rule out PE: No single ECG finding is sufficiently sensitive or specific to diagnose or exclude acute pulmonary embolism. A Normal ECG…
High Risk Pulmonary Embolism (PE)
Key Points: The ECG can provide an early warning of severe RV strain: No ECG finding defines high risk PE, but marked or evolving signs of acute RV pressure overload…
The Rhythm Behind the Irregularity
A 69-year-old woman presenting with sepsis gets the following ECG for tachycardia while febrile and shivering. The baseline is poor, atrial activity is difficult to identify, and the computer interpretation…
A Closer Look at the J Point
A 72-year-old man undergoes a prehospital 12-lead ECG. The tracing appears to show ST segment elevation in leads III, aVF, and aVR, raising concern for an inferior STEMI or high-risk…
Three High Risk ECGs and the Right Next Move
A 34 year old man presents with acute chest pain radiating to the left arm associated with diaphoresis. He has hyperlipidemia and a family history of early coronary disease. The…
Barcelona Criteria in Left Bundle Branch Block (LBBB): OMI Pattern
Key Points: The Barcelona Criteria are ECG criteria proposed to identify acute myocardial infarction in patients with LBBB. Core problem: LBBB causes expected secondary ST-T changes, so standard STEMI millimeter…
Aslanger Pattern: OMI Pattern
Key Points: Aslanger pattern is an OMI pattern that can identify acute inferior occlusion despite not meeting traditional STEMI criteria. The key finding is ST segment elevation isolated to lead…
Occlusion MI in Left Bundle Branch Block (LBBB): STEMI Equivalent Pattern
Key Points: LBBB does not exclude acute coronary occlusion. LBBBs produce abnormal depolarization and expected secondary ST-T changes, which can mask or mimic ischemia. Acute occlusion MI can still be…
J Point: Basics
Key Points: The J point is the junction between the end of the QRS complex and the beginning of the ST segment. It is a location, not a separate waveform….
Post-Cardiac Arrest ECGs Hub
Key Points: The first post-ROSC ECG is essential but imperfect. Obtain it immediately, but interpret it in context. Global ischemia, defibrillation, acidosis, hypothermia, vasopressors, artifact, and severe metabolic derangements can…
Post-Arrest STEMI: Cath Lab Decisions
Key Points: Persistent ST elevation after ROSC remains a guideline-supported indication for emergency coronary angiography. The 2025 ACC/AHA/ACEP/NAEMSP/SCAI ACS guideline recommends emergency angiography for patients after cardiac arrest with suspected…
Post-Arrest No STEMI: When Cath Can Wait
Key Points: Stable post-arrest patients without ST elevation should not go to reflex immediate cath solely because cardiac arrest occurred. Randomized trials in OHCA patients without ST elevation have not…
Pediatric ECG in Cardiac Arrest
Key Points: Pediatric arrest is usually respiratory, hypoxic, or shock-related, not primary coronary occlusion. The ECG still matters because it can reveal reversible metabolic, toxicologic, structural, inflammatory, or inherited electrical…
A Post-Arrest ECG With a Dangerous New Bundle Branch Block
A 72-year-old man is brought to the ED after a witnessed out-of-hospital cardiac arrest. Bystander CPR is started quickly, EMS finds a non-shockable rhythm, and ROSC is achieved after one…
ECG Learning Resources & Recommendations
Key Points: ECG STAT is designed for point-of-care review, but ECG mastery requires repeated exposure, active interpretation, feedback, assessment, and clinical correlation. Use the ECG Skills curriculum tracks as your…
Recommended Online ECG Resources
Key Points: Online ECG resources are best used for repeated case exposure, quick review, and pattern reinforcement. They should complement, not replace, a structured ECG curriculum. ECG STAT is designed…
Sinoatrial Exit Block
Key Points: Definition: Sinoatrial, or SA, exit block occurs when the sinus node generates an impulse that fails to conduct into the surrounding atrial tissue. The blocked impulse produces no…
Sinus Arrest
Key Points: Definition: Sinus arrest occurs when the sinus node temporarily fails to generate an impulse. This produces an absence of the expected P wave and its associated QRS complex….
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