Key Point BBs and CCBs are widely prescribed but overdoses can cause life-threatening bradycardia, AV block, hypotension, and shock. Differentiating between them is important, but both require early recognition, aggressive…
Key Point Cocaine is a powerful sympathomimetic with profound cardiovascular (CV) effects. Even recreational or first-time use can precipitate life-threatening complications, including myocardial infarction (MI), stroke, arrhythmias, and aortic dissection….
Key Points: Definition: An irregularly irregular rhythm occurs when the R-R intervals or P-P intervals vary with no consistent pattern, making the rhythm unpredictable and abnormal. Clinical Significance: Identifying an…
Key Points: Definition: A regularly irregular rhythm occurs when the distance between R-R intervals or P-P intervals varies in a consistent, repeating pattern throughout the ECG tracing. Significance: Determining the…
Key Points: Rhythm Regularity: Regular rhythm is characterized by equal distances between consecutive P waves (P-P intervals) and QRS complexes (R-R intervals). Verify rhythms with calipers—don’t trust the machine interpretation…
Key Points: Treat the patient, not just the number or rhythm. Start with a 10-second stability check. If the rhythm explains hypotension, shock, ischemic chest pain, altered mentation, or severe…
Key Points Definition: Phasic variation in sinus rate with respiration. P-P intervals shorten on inspiration and lengthen on expiration, producing a mild, patterned irregularity. Diagnostic threshold: Difference between the shortest…
Key Points Definition: Slow ventricular tachycardia is defined as a wide complex tachycardia with a ventricular rate between 100–120 bpm. Distinction: Typical sustained VT usually exceeds 120 bpm. When encountering…
Key Points Definition: Sinus pause/arrest is failure of the sinus node to generate an impulse, producing a transient absence of P waves. On ECG the pause does not equal an…
Key Points Definition: The R on T phenomenon occurs when an ectopic impulse (often a PVC or cardioversion shock) falls on the T wave of the preceding beat. Mechanism: Interrupting…
Key Points Definition: Multifocal Atrial Tachycardia (MAT) is a rare type of irregularly irregular supraventricular tachycardia (SVT) characterized by the presence of at least three or more different P wave…
Key Points: RV involvement accompanies up to ~40% of inferior STEMIs; isolated RV infarction is uncommon but high-impact when missed. Think RV MI when inferior STEMI is present and you…
Key Points: ECG as a Critical Diagnostic Tool: In toxicology, the ECG is often the first and most reliable clue. Early recognition of drug-induced conduction disturbances or arrhythmias can guide…
Key Points: What it is: In V2 or V3, there is no S wave (the R does not descend below the PQ baseline) and no J wave (no notch/slur at…
Key Points Narrow therapeutic window: Small dosing errors or renal decline can push serum digoxin above the safe range. Excess automaticity + AV block: Toxicity increases atrial and ventricular irritability…
Key Points: Definition: The QRS axis reflects the net direction of ventricular depolarization and is expressed in degrees on the frontal plane. Why It Matters: Axis assessment is a fast,…
Key Points Definition: Extreme axis deviation (aka “Northwest Axis”) occurs when the QRS axis is between –90° and ±180°. ECG Clue: QRS negative in Lead I QRS negative in Lead…
Key Points Definition: LAD occurs when the QRS axis is between –30° and –90°. ECG Pattern: QRS positive in Lead I QRS negative in Lead aVF Clinical Use: LAD can…
Key Points Definition: An indeterminate QRS axis (also called “no man’s land”) occurs when the frontal QRS vector lies between –90° and ±180°, but no dominant direction is evident. ECG…
Key Points Definition: Right Axis Deviation (RAD) occurs when the QRS axis is > +90°, typically up to +180°. ECG Criteria: Negative QRS in Lead I Positive QRS in Lead…