A 23-year-old woman presents with palpitations and lightheadedness after a spontaneous episode of regular wide complex tachycardia. Her post-conversion ECG shows anterior T wave inversions with a subtle abnormality hiding…
Key Points: Hypokalemia delays ventricular repolarization, producing progressive changes in the T-U complex before serious arrhythmias develop. ECG progression: T-wave flattening → mild ST depression → prominent U waves →…
Key Points: Severe hypokalemia can result in an arrhythmia emergency. The major threat is ventricular tachyarrhythmias, including torsades de pointes, polymorphic ventricular tachycardia, ventricular fibrillation, and sudden cardiac death. Severe…
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…
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…
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…
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…
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”:
A 52-year-old woman presents to the emergency department with severe malaise and the following ECG is obtained:
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
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…
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…
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:
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:
A 53-year-old woman presents to the emergency department with shortness of breath. The following ECG is obtained:
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…
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:
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:
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,…
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…