Emergencies
Results:
STEMI vs Artifact: DDx
Key Points: Not all ST elevation is ischemia. The most common mimics at the point of care are atrial activity riding on the ST segment, motion or lead artifact, early…
VT vs SVT with Aberrancy: DDx
Key Points ECG alone cannot reliably distinguish VT from SVT-aberrancy in many cases. Use ECG features to rule in VT, not to exclude it. Default: treat regular WCT as VT…
RV Outflow Tract Tachycardia (RVOT VT)
Key Points Idiopathic monomorphic VT arising from the right ventricular outflow tract. Most patients have no structural heart disease; catecholamine and cAMP-mediated triggers are common. Classic ECG pattern: LBBB morphology…
Hypokalemia
Key Points: Hypokalemia slows ventricular repolarization and alters the T–U complex before it triggers arrhythmias. Progressive pattern: T-wave flattening → prominent U waves → T–U fusion with apparent QT prolongation;…
Hypokalemia Emergencies
Key Points Severe hypokalemia can produce dramatic ECG changes that may be mistaken for acute coronary syndromes. It can also precipitate life-threatening arrhythmias, including torsades de pointes and ventricular tachyarrhythmias…
Understanding ECG Artifacts
Key Points Artifacts = non-cardiac signals that distort or obscure true ECG. They come from the patient, leads/equipment, or the environment. Clues to artifact: lacks a physiologic pattern, varies beat-to-beat…
Fascicular Ventricular Tachycardia (Idiopathic Left Fascicular VT)
Key Points Idiopathic reentrant VT arising within the left Purkinje system, most often the left posterior fascicle. Patients are usually young and lack structural heart disease. Signature ECG: RBBB-like morphology…
Opiate Toxicity
Key Point Opioid overdose causes life-threatening respiratory depression leading to hypoxia, altered mental status, bradycardia, hypotension, and potentially death. While most cardiovascular effects are secondary to hypoxia, methadone toxicity uniquely…
Methamphetamine Toxicity
Key Point Methamphetamine is a powerful sympathomimetic that causes a massive catecholamine surge, it can result in life-threatening cardiovascular and neurologic complications. Toxicity can present with MI, arrhythmias, stroke, hypertensive…
Beta-Blocker and Calcium Channel Blocker Toxicity
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…
Cocaine Toxicity
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….
Isorhythmic AV Dissociation
Key Points Definition: A type of AV dissociation in which sinus and escape rates are nearly identical, so P waves and QRS complexes appear to “track” each other while remaining unrelated….
Third-Degree AV Block (Complete Heart Block)
Key Points: Definition: Third-degree AV block is complete failure of conduction from atria to ventricles, resulting in independent atrial and ventricular activity—known as AV dissociation. Hallmark Feature: No P waves…
High-Grade (Advanced) AV Block
Key Points Definition: A severe form of second-degree AV block with two or more consecutive non‑conducted P waves (for example 3:1, 4:1). Do not force a Mobitz label when multiple…
Slow Ventricular Tachycardia (VT)
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…
Sinus Arrest
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…
R-on-T Phenomenon
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…
Right Ventricular STEMI: Criteria & Pitfalls
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…
Second-Degree AV Block Type I (Mobitz I/Wenckebach)
Key Points: Definition: Progressive PR interval prolongation until one atrial impulse fails to conduct to the ventricles (P wave is non-conducted), after which the cycle repeats. Site of Block: Typically…
Second-Degree AV Block with 2:1 Conduction
Key Points: Definition: A form of second-degree AV block in which every other atrial impulse is blocked, producing a 2:1 atrioventricular conduction ratio. Typing Limitation: Differentiating between Mobitz I and…
ECG Tags
- A-Z
- ACS Mimics
- ACS-OMI
- Activation
- Advanced Level Curriculum
- Annual ECG Competition
- Anterior OMI
- Anterior STEMI
- Approach
- Arrest
- Arrhythmia
- Artifact
- Attending
- AV Block
- aVF
- aVL
- aVR
- Axis
- Basics
- Board Review
- Bradyarrhythmia
- Chest Pain
- Clumped Beats
- Conduction
- Core
- Core Level Curriculum
- Critical ECG Patterns
- Curriculum
- DDx
- Delta
- Devices
- Diagonal Branch Occlusion
- Differential Diagnoses
- Diffuse ST Elevation
- Documentation
- Early Repolarization
- ECG Interpretation
- ECG Localization
- ECG Variant
- Education/Teaching
- Electrolytes
- Emergencies
- Emergent Cath Lab Activation
- EMS
- Expert Level Curriculum
- Foundations Level Curriculum
- Guidelines
- High-Lateral STEMI
- Hub
- Hyperacute T waves
- Hypercalcemia
- Hyperkalemia
- Hypermagnesemia
- Hypocalcemia
- Hypokalemia
- Hyponatremia
- Hypothermia
- I
- II
- Index
- Inferior OMI
- Inferior STEMI
- Intervals
- Irregular
- Ischemia
- Ischemia & Infarction
- J Waves
- JT
- LAD Occlusion
- Lateral STEMI
- LBBB
- LCx Occlusion
- Lead Placement
- Life Savers
- LV an
- LV Aneurysm
- Mastery Level Curriculum
- Metabolic
- Mimics
- Narrow QRS
- Occlusion MI
- OMI Pattern
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- Osborn Waves
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- PGY-1
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- Post-Cardiac Arrest
- Posterior Extension
- Posterior MI
- Posterior STEMI
- PR
- Preexcitation
- Premature Complexes
- Prolonged QT
- Pulmonary Embolism
- Pulse-Tapping Artifact
- PVCs
- Q Wave
- QRS
- QT
- R Waves
- RAD
- Rate
- RBBB
- RCA Occlusion
- Regular
- Reperfusion
- Rhythm
- RR
- S Waves
- Segments
- Seizure
- Serial ECGs
- Shock
- ST
- ST Depression
- ST Elevation
- STEMI
- STEMI Equivalent
- STEMI Mimics
- STEMI Negative OMI
- Stepwise
- Stroke
- Structural
- Students
- SVT
- Syncope
- T Waves
- Tachyarrhythmia
- Tachycardia
- Tamponade
- Terminal QRS Distortion
- Toxicology
- TP
- Traditional STEMI Criteria
- U Waves
- Unstable
- V1-V4
- V5
- V6
- Vectors
- Ventricular Repolarization
- Ventricular Rhythms
- Ventricular Tachycardia
- Voltage
- Waveforms
- Wide QRS
- Workflow
- WPW
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