Emergencies

ECG STAT July 28, 2025

Second-Degree AV Block Type II (Mobitz II)

Key Points Definition: Sudden failure of AV conduction after at least two consecutive conducted beats with identical PR intervals, followed by a single non‑conducted P wave. Sinus rate: P–P interval…

ECG STAT July 25, 2025

Toxicologic Emergencies

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…

ECG STAT July 17, 2025

Terminal QRS Distortion: OMI Pattern

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…

ECG STAT July 16, 2025

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…

ECG STAT July 15, 2025

Right Axis Deviation + ST Elevation: DDx

Key Points RAD combined with ST-segment elevation (STE) is an uncommon but high-risk finding. While STE often suggests acute coronary occlusion, this pattern rarely reflects classic STEMI. Several non-ischemic conditions…

ECG STAT July 7, 2025

Computer Interpreted “Normal” ECGs

Key Points Do not fully trust computer interpretations of “normal” ECGs, they may miss significant abnormalities. Computer algorithms can miss early ischemic signs such as reciprocal changes in aVL and…

ECG STAT July 1, 2025

Pseudonormalization of T Waves

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…

ECG STAT June 17, 2025

Occlusion MI in Ventricular Paced Rhythms: STEMI Equivalent Pattern

Key Points 1. Paced Rhythms and Acute MI Detection: Ventricular paced rhythms significantly alter ST segment and T wave morphology, complicating acute myocardial infarction (MI) recognition. Accurate ECG interpretation in…

ECG STAT June 17, 2025

Occlusion MI in Left Bundle Branch Block: STEMI Equivalent Pattern

Key Points LBBB Does Not Exclude Acute Coronary Occlusion: LBBB alters ventricular activation, leading to expected secondary ST/T abnormalities. However, acute occlusion myocardial infarction (OMI) can and must still be…

ECG STAT June 14, 2025

Modified Sgarbossa Criteria: STEMI Equivalent Pattern

Key Points Wide QRS Rhythms Can Mask OMI: Left bundle branch block (LBBB) and right ventricular (RV)-paced rhythms alter ventricular depolarization, producing expected secondary ST/T changes. However, acute occlusion MI…

ECG STAT June 6, 2025

Hyperkalemic Periodic Paralysis (Impressive Syndrome)

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…

ECG STAT May 14, 2025

Trifascicular Block

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:…

ECG STAT May 12, 2025

Sinus Node Dysfunction (Sick Sinus / Brady-Tachy Syndrome)

Key Points Spectrum, not one rhythm: Look for sinus brady, pauses, arrest, alternating atrial tachyarrhythmias (AF, flutter, ATach). Symptoms matter: Syncope, presyncope, fatigue usually come from cerebral/systemic hypoperfusion, especially after…

ECG STAT May 8, 2025

Short QT Syndrome

Key Points Short QT Syndrome (SQTS) is a rare condition characterized by a shortened QT interval on the ECG, increasing the risk of atrial and ventricular arrhythmias, including sudden cardiac…

ECG STAT April 25, 2025

Slow Atrial Fibrillation

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,…

ECG STAT April 25, 2025

Sinoatrial Exit Block

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…

ECG STAT April 24, 2025

Aslanger Pattern: OMI Pattern

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…

ECG STAT April 20, 2025

Precordial Swirl: OMI Pattern

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…

ECG STAT April 11, 2025

Pulmonary Embolism (PE)

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…