Hypokalemia
Results:
Himalayan T Waves
Key Points Tall, broad-based T–U fusion that looks like a mountain peak, usually from severe hypokalemia; think high torsades risk until proven otherwise. Hallmark is prolonged repolarization: QT appears long…
Recent ECG Case Highlights from the University of Maryland (Part II)
A 67-year-old man arrives at the emergency department complaining of lightheadedness. The following ECG is obtained and shows a slow, regular rhythm around 40 beats per minute. The P waves…
U Wave: Basics
Key Points Definition and origin: The U wave is a small deflection following the T wave, best seen in V2–V3. It likely reflects late ventricular repolarization or Purkinje repolarization. Normal…
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…
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…
2024 UMMC Cases (Part III)
A 67-year-old man arrives at the emergency department with palpitations. He is noted to be tachycardic at triage and the following ECG is obtained and interpreted as “sinus tachycardia”:
What’s Behind These Strange T Waves?
A 52-year-old woman presents to the emergency department with severe malaise and the following ECG is obtained:
Interesting Cases from UMMC (2024 – Part II/III)
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
2024 EM Boards ECG Review (Part II/II)
A 55-year-old man with a known left bundle branch block presents to ABEM general hospital with acute chest pain. Vital signs are normal and his pain is slightly improved with…
Paralysis Unmasked: Impressive ECGs That Saved the Day
A 45-year-old woman with PMHx of HTN, DM, ESRD (MWF hemodialysis) presents with complete paralysis below the neck. She reports being normal and fully functional before going to bed the…
5 more challenging cases from UMEM to test your ECG diagnostic skills
A 64-year-old woman presents to the ED with chest discomfort associated with multiple episodes of nausea and vomiting. The following ECG is obtained on arrival:
4 challenging cases from UMEM to test your ECG diagnostic skills
A 75-year-old woman presents to the ED with palpitations. She is found to be tachycardic at triage. The following ECG is obtained on arrival:
Differential Diagnoses: poor R wave progression, prolonged QT intervals, and much more
A 53-year-old woman presents to the emergency department with shortness of breath. The following ECG is obtained:
Differential Diagnoses: narrow complex irregular tachycardia, short QTc intervals, ST segment elevation in aVR, and so much more!
An 89-year-old woman is brought into the emergency department with generalized weakness and dizziness. She is noted to be bradycardic at triage. The following ECG is obtained with no prior…
STAT ECG Diagnoses: considerations in patients with altered mental status and seizures
A 39-year-old male with no significant PMHx presents to the ED after a seizure. He is post-ictal on arrival. Vital signs are normal, and the following ECG is obtained:
Potpourri of cases: critical electrolyte abnormalities, clumped or grouped beats, and so much more!
A 73-year-old man presented to the ED with chest pain and is noted to be hypotensive (95/45). The following ECG was obtained:
STAT ECG Diagnoses: the value of ECGs in acute neurological emergencies
A 54-year-old male presented to the emergency department with inability to walk for 3 days s/p appendectomy. He reports feeling ill and generally weak. He denies abdominal pain, fever, nausea,…
2019 ECG Competition Answers (Part 1/3)
This week we review the answers to the first 6 questions from the 7th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…
The many causes of ST segment elevation in aVR and a discussion on the ECG findings in severe hypokalemia
A known local alcoholic presents to the emergency department with weakness. The patient has been laying on a mattress in a field for most of the past week. He says…
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