Key Points BRASH is a synergistic spiral: bradycardia, renal failure, therapeutic AV-nodal blockade, shock, and hyperkalemia. The signature clue is disproportionate brady-shock despite only modest potassium elevation. Do not be…
Key Points Tension pneumothorax is a clinical diagnosis—ECG changes are nonspecific but can provide supportive evidence in the right context. Electrical changes are primarily due to mechanical effects of air…
Key Points Aortic dissection or aneurysm can produce ischemic‑appearing ECGs due to coronary malperfusion, most often right coronary involvement causing inferior changes. Pseudo‑infarction patterns, ST‑deviation, and conduction blocks can occur…
Key Points Definition: The ST segment runs from the J point (end of QRS) to the start of the T wave, the interval between ventricular depolarization and repolarization. Normal: Usually…
Key Points Definition: Chronic pressure/volume overload → thickened RV (pulm HTN, congenital lesions, pulmonary disease). ECG signature: Rightward axis, dominant R in V1, deep S in V5–V6, with possible right-sided…
Key Points Definition and Measurement: A Q wave is the first negative deflection of the QRS. Measure width in ms from the onset below baseline to its return to baseline;…
Key Points Definition and measurement: The QRS complex is ventricular depolarization, measured from the earliest ventricular deflection (Q or R) to the latest S return to baseline in any lead….
Key Points Definition: The R wave is the first positive deflection of the QRS complex, reflecting early ventricular depolarization, predominantly of the left ventricle. Normal progression: Precordial R amplitude increases…
Key Points ECG red flags: Bradycardia, PR/QRS/QT prolongation, flattened P, peaked T, → AV block/asystole at higher levels. Neuromuscular: Hyporeflexia → weakness → respiratory depression → coma. Immediate countermeasure (severe/symptomatic):…
Key Points Mechanism: Block in the left anterior fascicle → ventricular activation proceeds down the left posterior fascicle, then spreads inferior-to-superior and right-to-left across the LV. ECG signature: Left axis…
Key Points Definition: The PR segment is the flat line from the end of the P wave to the beginning of the QRS. It reflects conduction through the AV node,…
Key Points Definition: The TP segment is the isoelectric interval from the end of the T wave to the start of the P wave. It reflects electrical diastole when the…
Key Points Definition and origin: The U wave is a small deflection following the T wave, best seen in V2–V3. It likely reflects late ventricular repolarization or Purkinje repolarization. Normal…
Key Points Definition: The T wave reflects ventricular repolarization. Measure amplitude from baseline to peak and identify the end of T to help define the QT interval. Normal appearance: Upright…
Key Points Definition and measurement: The S wave is the first negative deflection after the R wave within the QRS. Measure depth in mm from baseline to nadir; width contributes…
Key Points: Complexity of ACS: Arteries can spontaneously reperfuse or re-occlude. Understanding early ECG patterns of early acute ischemia can help detect dynamic changes and prompt rapid interventions. ECG Pattern…
Key Points Continuous-flow LVADs can mask shock: patients may talk through VT/VF because pump flow maintains some perfusion. Treat the rhythm, not the appearance. First steps in any unstable LVAD…
Key Points Rare, inherited ventricular arrhythmia triggered by adrenergic stress during exertion or emotion. Classically presents in children or adolescents with syncope or cardiac arrest despite a normal resting ECG…
Key Points Always get a 12-lead ECG in altered or confused patients. The ECG is a great triage and risk stratification tool and can reveal reversible, life-threatening causes when history…
Key Points A Simple Yet Powerful Tool: With just a piece of paper and some ink, the ECG can be the earliest clue to life-threatening metabolic disease when labs are…