Emergencies
Results:
Nonsustained Ventricular Tachycardia
Key Points Definition: NSVT is defined as ≥3 consecutive ventricular beats, QRS duration >120 ms, rate typically 100-250 bpm (usually > 120 bpm), lasting less than 30 seconds without causing…
EMS ECGs in Acute Coronary Syndromes (ACS)
Key Points for EMS Providers: You are the first critical link in the chain of survival for ACS patients—your actions set the course for their care, directly impacting time to…
Atrial Fibrillation with WPW
Key Points: WPW Syndrome: A condition characterized by ventricular pre-excitation due to a congenital accessory pathway, often associated with symptomatic arrhythmias. ECG Recognition: The WPW pattern is best identified when…
Subtle ST Segment Elevation: OMI Pattern
Key Points ACS Dynamics: Occluded arteries in ACS can spontaneously reperfuse and reocclude, making ECG findings variable. Limitations of Computer Interpretation: Subtle STE is often missed by computerized ECG interpretation;…
South African Flag Sign: OMI Pattern
Key Points Pattern Recognition: The South African Flag Sign is characterized by: ST-segment elevation (STE) in leads I, aVL, and V2. ST-segment depression in lead III. Subtle but visually distinctive…
Brugada Syndrome (BrS)
Key Points Life-Threatening Sodium Channelopathy: Predisposes to ventricular arrhythmias (VF/VT) and sudden cardiac death (SCD), often in otherwise “healthy” hearts. When to Suspect BrS: Patients with syncope, unexplained “seizures,” ventricular…
Hypokalemic Periodic Paralysis
Key Points Definition: A rare ion channelopathy that causes sudden, reversible episodes of symmetric flaccid paralysis triggered by low serum potassium. It may be inherited or secondary to thyrotoxicosis or…
Hypomagnesemia
Key Points Prolonged QT & PR Intervals significantly increase the risk of torsades de pointes and other arrhythmias. Atrial & Ventricular Ectopy is common; can progress to life-threatening ventricular tachycardia….
Arrhythmogenic Cardiomyopathy (ACM)
Key Points Definition & Terminology: Arrhythmogenic Cardiomyopathy (ACM), previously known as Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D), is an inherited disorder characterized by progressive fibrofatty replacement of the ventricular myocardium, predominantly…
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…
Upright T Waves in V1
Key Point Normal T Wave in V1: The normal ECG typically shows a flat or inverted T-wave in lead V1. Upright T-Wave Abnormality: An upright T-wave in V1 (TV1) should…
WPW with Antidromic SVT
Key Points WPW Syndrome: Wolff-Parkinson-White (WPW) syndrome is a condition characterized by ventricular pre-excitation due to a congenital accessory pathway in patients with symptomatic arrhythmias. ECG Recognition: The classic WPW…
WPW with Orthodromic SVT
Key Points WPW syndrome is caused by congenital ventricular pre-excitation via an accessory pathway. The classic sinus rhythm pattern includes a short PR interval, delta wave, and a widened QRS,…
Wide Complex Tachycardias: does response to Valsalva maneuvers or adenosine rule out ventricular tachycardia?
A 54-year-old man with no significant PMHx presents to the ED with palpitations. He is hemodynamically stable with a normal blood pressure. The following ECG is obtained prior to the…
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