Emergencies

Results:
ECG STAT April 1, 2026
Polymorphic Ventricular Tachycardia (PMVT)

Key Points: Definition: Polymorphic ventricular tachycardia is VT with beat-to-beat variation in QRS morphology, axis, and amplitude. Clinical significance: PMVT is electrically unstable and can rapidly deteriorate into ventricular fibrillation…

Weekly Workout March 30, 2026
UMEM Cases, Part 1: When the ECG Lies and When It Evolves

A 72-year-old man presents with chest pain and shortness of breath. His ECG shows sinus rhythm with LVH, mild inferior ST elevation, and lateral ST-T abnormalities that some interpret as…

ECG STAT March 20, 2026
Nonsustained Ventricular Tachycardia (NSVT)

Key Points: Definition: Nonsustained ventricular tachycardia is 3 or more consecutive ventricular beats lasting less than 30 seconds and terminating spontaneously. Rate: VT is usually faster than 120 bpm, but…

ECG STAT March 20, 2026
STEMI vs Wide QRS (BBBs & Paced Rhythms): DDx

Key Points: Wide QRS rhythms distort repolarization. Bundle branch block and ventricular pacing create secondary ST-T changes even without occlusion MI. Appropriate discordance is expected. ST segments and T waves…

ECG STAT March 20, 2026
South African Flag Sign: OMI Pattern

Key Points: Pattern: The South African Flag sign is the combination of ST elevation in I, aVL, and V2 with reciprocal ST depression in III. It is a subtle but…

Weekly Workout March 16, 2026
Three ECG Traps You Cannot Afford to Miss

A 60-year-old woman presents with palpitations and an irregular wide-complex tachycardia. The computer calls atrial fibrillation with a left bundle branch block, but a subtle clue in the precordial leads…

ECG STAT March 11, 2026
Occlusion MI in Ventricular Paced Rhythms: STEMI Equivalent Pattern

Key Points: Ventricular paced rhythms can mask acute coronary occlusion. Pacing alters depolarization and produces expected secondary ST-T abnormalities, so standard STEMI criteria are unreliable. Appropriate discordance is expected in…

ECG STAT March 11, 2026
The Life Savers: Critical ECGs Hub

Key Points: Life Savers are the can’t-miss ECGs. These patterns may reflect immediately life-threatening ischemic, electrical, mechanical, obstructive, toxicologic, or metabolic emergencies. This hub is built for rapid action. Use…

Weekly Workout March 9, 2026
The Syncope ECG With Too Much P

A 68-year-old man has syncope, then has a second syncopal episode while lying still on a stretcher during evaluation at an outpatient clinic. He is sent emergently to the ED….

ECG STAT March 7, 2026
Electrical Alternans

Key Points: Electrical alternans is a beat-to-beat alternation in QRS amplitude, axis, or both. It is classically associated with a large pericardial effusion and may support concern for tamponade, but…

ECG STAT March 7, 2026
Pericardial Effusion

Key Points: Pericardial effusion is the accumulation of fluid in the pericardial sac. ECG may provide clues, but it is not sensitive enough to exclude effusion. Important ECG clues include…

ECG STAT March 7, 2026
STEMI vs LVH: DDx

Key Points: Left ventricular hypertrophy (LVH) with strain is one of the most common and dangerous STEMI mimics, particularly in the anterior leads, and is a frequent cause of false-positive…

ECG STAT March 7, 2026
Pericardial Tamponade

Key Points: Pericardial tamponade is a hemodynamic diagnosis, not just an ECG diagnosis. ECG may show sinus tachycardia, low-voltage QRS, and sometimes electrical alternans, but none are sensitive enough to…

ECG STAT March 6, 2026
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…

Weekly Workout March 2, 2026
Preexcitation Pitfalls (Part 4): Potpourri Cases & Final Teaching Points

A 49-year-old man arrives with palpitations and chest discomfort. The monitor shows an irregular, wide-complex tachycardia with varying morphology and rates nearing 250 to 300 bpm. The team debates polymorphic…

ECG STAT March 1, 2026
Isorhythmic AV Dissociation

Key Points: Isorhythmic AV dissociation is a form of AV dissociation in which the sinus rate and junctional or ventricular escape rate are nearly identical, making the P waves and…

ECG STAT March 1, 2026
Third-Degree AV Block (Complete Heart Block)

Key Points: Third-degree AV block is complete failure of atrial impulses to conduct to the ventricles. The defining ECG feature is AV dissociation with no conducted P waves. The atrial…

ECG STAT March 1, 2026
Second-Degree AV Block Type I (Mobitz I/Wenckebach)

Key Points: Mobitz I is defined by progressive PR prolongation until a single P wave fails to conduct, after which the cycle resets. The block is usually at the AV…

ECG STAT March 1, 2026
Second-Degree AV Block with 2:1 Conduction

Key Points: Second-degree AV block with 2:1 conduction means every other P wave conducts and every other P wave is blocked. A single ECG with 2:1 conduction usually cannot be…

ECG STAT March 1, 2026
Second-Degree AV Block Type II (Mobitz II)

Key Points: Mobitz II is defined by sudden failure of AV conduction after at least 2 consecutive conducted beats with fixed PR intervals and no preceding PR prolongation. The block…

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