Top 3 Emergent Causes of New Rightward Axis Deviation: When you see new RAD in an adult, immediately consider life-threatening etiologies: Acute Right Heart Strain Pulmonary embolism until proven otherwise…
Key Points Normal Axis Range: –30° to +90° Lead I: QRS complex is positive Lead aVF: QRS complex is positive → This combination confirms a normal QRS axis Frontal plane…
Key Points: Intervals are your ECG safety rails. Before you get seduced by ST segments and T waves, lock down PR, QRS, and QT/QTc. They frequently reveal the real danger…
Key Points Definition: A fusion beat occurs when two impulses — one from the normal conduction system (typically supraventricular) and one from an ectopic ventricular focus (e.g., during VT) —…
Key Points The ECG is a cornerstone of acute care medicine, offering immediate, non-invasive insight into cardiac function in critically ill patients. Its evolution spans over a century, from rudimentary…
Key Points Definition: Pseudonormalization is the apparent normalization of previously inverted T waves, often signaling reocclusion of a coronary artery that had recently reperfused. Mechanism: During reperfusion, ischemic T wave…
Key Points RBBB delays right ventricular activation. The left ventricle depolarizes normally via the left bundle; the right ventricle is activated late through myocardial spread. ECG hallmark: wide QRS and…
Key Points Definition: Sinus tachycardia is a regular rhythm originating from the sinoatrial (SA) node, defined by a heart rate >100 bpm in adults or above age-adjusted norms in children….
Key Points What It Is: A rare autosomal dominant sodium channelopathy that leads to episodic muscle weakness or paralysis in the setting of elevated serum potassium. Named after “Impressive,” the…
Key Points Definition: Trifascicular block describes ECG evidence of impaired conduction across all three fascicles: right bundle branch (RBB), left anterior fascicle (LAF), and left posterior fascicle (LPF). Common Usage:…
Key Points: Definition: Sinus bradycardia is a rhythm originating from the sinoatrial (SA) node with a rate < 60 bpm. Physiological Occurrence: Common in young, healthy adults, athletes, and during…
Key Points Definition: Atrial fibrillation with a slow ventricular response, usually < 60 bpm. ECG: Irregularly irregular rhythm, no discrete P waves, slow R-R intervals. Common causes: AV-nodal blockers (digoxin,…
Key Points Definition: SA exit block occurs when the sinus node generates impulses that are blocked before they can activate the right atrium, leading to dropped P waves on the…
Key Points: STEMI Diagnosis and Contiguous Leads: While current guidelines typically require ST elevation (STE) in at least two contiguous leads for the diagnosis of STEMI, this practice is not…
Key Points Definition: The precordial swirl sign refers to a rotational pattern of ST-segment abnormalities across the precordial leads, suggesting a dynamic and evolving occlusion myocardial infarction (OMI). It is…
Key Points Definition: Unifascicular block refers to conduction delay or interruption in a single fascicle of the ventricular conduction system: the right bundle branch (RBB), left anterior fascicle (LAF), or…
Key Points ECG Findings in PE: No single ECG pattern is diagnostic of acute PE, and ECG findings are typically nonspecific. However, certain ECG patterns, especially those indicating right heart…
Key Points: Definition: QRS voltage represents the amplitude (height) of the QRS complex on ECG, reflecting ventricular electrical activity during depolarization. High Voltage: Increased QRS voltage typically indicates ventricular hypertrophy—most…
Key Points Definition: PMVT is a ventricular tachycardia characterized by beat-to-beat variations in QRS morphology, axis, and duration, reflecting multiple ventricular foci or reentrant circuits. Clinical Importance: PMVT is often…
Key Points: Recognizing the Danger: Sodium channel blocker toxicity can present with a variety of ECG changes that are critical to recognize, especially in patients with altered mental status or…