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: Definition: Hypokalemic periodic paralysis (HPP) is a rare disorder characterized by episodic, reversible flaccid muscle weakness associated with a shift of potassium from the extracellular space into skeletal…
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…
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…