limb lead misplacement
Results:
Cannabis Use and Premature Atherosclerosis: An ED Risk Factor To Ask About?
A 36-year-old man with hypertension and regular cannabis use (edibles, ~3x/week) is referred from clinic to the ED for chest pain and an abnormal ECG. His first ECG during pain…
ECG Lead Misplacement
Key Points Lead misplacement is common and can mimic ischemia, MI, conduction blocks, and arrhythmias. Always verify placement when ECG and clinical picture do not match. V1 and V2 placed…
Recent University of Maryland Medical Center Cases (Part I)
A 67-year-old man presents to the emergency department with chest pain and palpitations. The following ECG is obtained on arrival:
The Approach to Uncovering Hidden STEMI
A 92-year-old man presents to the emergency department with acute chest pain and diaphoresis. The following ECG is obtained:
ECG Basics and Fundamentals: Limb Lead Reversal
A 82-year-old woman presents to the ED “not feeling well”. She reports malaise, mild dyspnea, but denies any pain. Vital signs are normal. The following ECG is obtained on arrival…
ECG Tags
- & Myocardial Ischemia
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- 3rd degree AV block
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- Adenosine
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- AI
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- arrhythmogenic cardiomyopathy
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- Arrhythmogenic RV Dysplasia
- Artifact
- artifact vs. malignant arrhythmias
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- Artificial Intelligence
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- Atrial flitter
- Atrial flutter
- Atrial Flutter 1:1 Conduction
- atrial flutter 2:!
- atrial flutter 2:1 conduction
- atrial flutter mimics
- Atrial Flutter with Variable Conduction
- Atrial parasystole
- Atrial septal defect
- Atrial Septal Defect (ASD) & Crochetage Pattern
- Atrial tachycardia
- Atrifact
- Atrioventricular blocks
- Atrioventricular Blocks (AVB) Summary
- Atrioventricular Nodal Reentry Tachycardia
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- Attending Level Curriculum
- AV Block
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- Benign early repolarization
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- Beta-Blocker (BB) and Calcium Channel Blocker (CCB) Toxicity
- bidirectional ventricular tachycardia
- Bidirectional Ventricular Tachycardia (BiVT)
- bifascicular block
- bifid p waves
- bigeminy
- Biphasic T-waves
- Bix rule
- Bizzare rhythm
- Blocked PAC’s
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- bpm
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- cannabis
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- Cardioversion
- Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)
- Catecholaminergic Polymorphic VT (CPVT)
- CCB toxicity
- Cerebral T waves
- Cerebral T Waves (Neurogenic “Roller Coaster” T Waves)
- CHB
- Chemotherapy
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- child
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- Chronic Obstructive Pulmonary Disease
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- clumped beats
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- cocaine
- cocaine chest pain
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- Complete Heart Block
- Computer ECG interpretation
- Computer interpreted ECGs
- Computer interpreted electrocardiograms
- congenital long QT syndrome
- congenital short QT syndrome
- COPD
- coronary angiography
- Corrected QT interval
- COVID-19
- Critical ECG Emergencies
- Crochetage
- Crochetage pattern
- ddx
- DDx for TWIs in V1-V3
- de Winter
- de Winter T-wave
- de Winter T-waves
- defibrillation
- Delta waves
- deWinter
- deWinter T-waves
- Dextrocardia
- differential diagnoses
- differential diagnoses for left axis deviation
- Diffuse ST elevation
- Diffuse ST Elevation DDx
- Diffuse ST-segment Elevation
- Diffuse STE
- dig effect
- digoxin
- Digoxin effect
- Digoxin toxicity
- DKA
- Dominant R wave
- Dominant R wave in aVR
- Dominant R wave in V1
- dresslers
- dresslers syndrome
- dynamic ecg changes
- Dysrhythmia
- Dysrhythmia in LVADs
- Dysrhythmias
- Dysrhythmias in LVAD Patients
- Earliest ECG Evidence of Occlusion MI
- Earliest Evidence of Occlusion MI
- Early cardiac ischemia
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- Early ischemia
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- Early Repolarization
- early repolarization vs/ STEMI
- early signs of cardiac ischemia
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- Early STEMI
- ecg 101
- ECG Basics
- ECG competition
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- ECG Evidence of Reperfusion After Occlusion
- ECG Findings in Aortic Emergencies
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- ecg history
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- ECG Lead Misplacement
- ECG Signs of Aortic Emergencies
- Ectopic atrial rhythm
- Ectopic beats
- electrical alternans
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- Electrocardiographic polyuria
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- Electrolytes
- Elevated intracranial pressure
- Emergent cath lab activation
- EMS
- EMS cases
- EMS ECG
- EMS ECGs
- EMS ECGs in Acute Coronary Syndromes (ACS)
- Epsilon waves
- escape rhythm
- escape rhythms
- Escape-Capture
- Escape-Capture Bigeminy
- evolution of ecg
- Evolving STEMI
- extreme axis deviation
- Extreme Axis Deviation Basics
- Extreme Axis Deviation DDx
- Extreme Axis Deviation Differentials
- failure to capture
- failure to pace
- failure to sense
- Fascicular blocks
- Fascicular Ventricular Tachycardia (Idiopathic Left Fascicular VT)
- fever
- First-Degree AV Block
- Flattened T Waves
- Flutter Waves (F waves)
- Foundational Resident
- Framingham formula
- Fridericia formula
- Fusion Beats
- generic PMVT
- GERD
- Griffith
- grouped beats
- Guidelines
- HCM
- Heart block
- heart rate
- heart rate and rhythm basics
- heart rate basics
- heart rhythm
- heart rhythm interpretation
- High grade AV block
- high grade AV blocks
- high lateral STEMI
- high left ventricular voltages and 'dagger like' Q waves
- high risk pe
- High Voltage
- High-Grade (Advanced AV Block)
- high-risk pulmonary embolism
- Himalayan T-waves
- history of ecg
- History of presenting illness
- HOCM
- Hodges formula
- Hypeacute T waves
- hyperacute
- Hyperacute T-waves
- Hypercalcemia
- Hyperkalemia
- Hyperkalemia emergencies
- hyperkalemia mimics
- Hyperkalemia vs. STEMI
- Hyperkalemia vs. VT
- Hyperkalemic paralysis
- Hyperkalemic Periodic Paralysis
- Hyperkalemic Periodic Paralysis (“Impressive Syndrome”)
- Hypermagnesemia
- Hypertrophic
- Hypertrophic Cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Hypocalcemia
- Hypokalemia
- hypokalemia emergencies
- Hypokalemic paralysis
- hypokalemic periodic paralysis
- Hypomagnesemia
- hyponatremia
- Hypothermia
- Idiopathic monomorphic VT
- Idiopathic VT
- Idioventricular rhythms
- Impressive syndrome
- in-training exam
- inappropriate sinus tachycardia
- incomplete right bundle branch block
- indeterminate axis
- Indeterminate Axis DDx
- Indeterminate Axis differentials
- indeterminate QRS axis
- inferior STEMI
- inservice exam
- intermittent
- Intermittent WPW
- intervals
- Intracranial hemorrhage
- Intractable chest pain
- inverted P Waves
- Inverted T Waves
- Inverted U-waves
- IRBBB
- Irregular rhythm
- irregular rhythms
- Ischemia
- Ischemia & Infarction
- Ischemic T-waves
- Isoelectric baseline
- Isoelectric segment
- Isoelectric Segment of the ECG
- Isolated Posterior STEMI
- Isorhythmic AV dissociation
- Isorhythmic AVD
- ITE prep
- ITE review
- J point
- J Point Basics
- J wave
- J-waves
- Jervell
- Jervell and Lange-Nielsen Syndrome
- JLNS
- Josephson Sign
- Josephson’s sign
- junctional escape
- junctional escape capture bigeminy
- junctional escape rhythms
- junctional rhythm
- Junctional rhythms
- Junctional Tachycardia
- Juvenile T wave inversions
- Juvenile T waves
- Juvenile T-wave pattern
- kid
- kid ecg
- kids
- killer differentials
- LAD
- LAD OMI
- LAE
- LAFB
- Lange
- Large T Wave DDx
- Large T-waves
- LBBB
- LBBB DDx
- lead misplacement
- lead V1
- left anterior fascicular block
- Left Atrial Enlargement
- Left axis deviation
- left axis deviation ddx
- left bundle branch block
- left posterior fascicular block
- Left Ventricular Hypertrophy (LVH)
- Left ventricular hypertrophy vs. STEMI
- lewis
- Lewis lead
- LGL
- life savers
- limb lead misplacement
- Limb lead reversal
- Literature review
- Long QT
- Long QT Interval DDx
- Long QT-interval
- Long QTc
- long ST segment
- Low Voltage
- low voltage differential
- Low voltage QRS
- Low Voltage QRS DDx
- LPFB
- LQT1 (KCNQ1 Mutation)
- LQT2 (KCNH2 Mutation)
- LQT3 (SCN5A Mutation)
- LQTS
- LV Aneurysm
- LV Aneurysm vs. STEMI
- LVAD
- LVAD Dysrhythmias
- LVADs
- LVH
- LVH vs. STEMI
- LVH with strain pattern
- Lyme carditis
- Marijuana
- marijuana toxicity
- Massive STEMI
- MAT
- Mechanisms of ACS
- Metabolic Emergencies
- meth
- methamphetamine
- Methamphetamine Toxicity
- MI
- mimics
- misplaced leads
- Mobitz
- Mobitz conduction
- Mobitz I
- Mobitz I (Wenckebach)
- Mobitz I or Mobitz II: How to tell the difference
- Mobitz II
- Mobitz II (Hay)
- Mobitz II AV block
- modified lead
- Modified Sgarbossa criteria
- Monomorphic Ventricular Tachycardia
- Monomorphic Ventricular Tachycardia (MMVT)
- monomorphic VT
- mth
- Multifocal atrial tachycardia
- Myocarditis
- Myxedema
- Na channel blocker toxicity
- narrow & irregular tachycardia
- narrow & regular tachycardia
- Narrow complex and regular rhythms
- Narrow complex irregular rhythms
- Narrow complex irregular tachycardia
- Narrow Complex Regular Tachycardia
- narrow complex regular tachycardia differential
- Narrow Complex Tachycardia
- narrow qrs bradycardia
- Narrow QRS Bradycardia DDx
- New Q Waves
- New RBBB and LAFB
- Nielsen
- Nikelekam T-waves
- No clear P waves DDx
- no man's land
- Non-conducted P wave (P:QRS>1) DDx
- non-conducted P waves
- non-conducted PACs
- Non-STE ACS
- Non-sustained Ventricular tachycardia
- Non-sustained VT
- Nonspecific intraventricular conduction delay
- nonsustained
- nonsustained ventricular tachycardia
- Nonsustained VT
- normal
- Normal Cardiac Conduction
- Normal ECG
- normal heart rate
- Normal Heart Rate Ranges by Age
- normal lead placement
- normal qrs axis
- Normal R wave progression
- Normal Sinus Rhythm
- Normal STAT ECG
- Normal variant patterns
- normal variant ST elevation
- Normal variants
- Not Enough P Waves (P:QRS < 1) DDx
- Not normal ecg
- NSVT
- Occlusion MI
- Occlusion MI - STEMI Criteria & Beyond
- Occlusion MI patterns
- OMI
- OMI pa
- OMI Pattern
- OMI Pattern: ST Depression V1-V4
- OMI Patterns in Left Bundle Branch Block
- OMI Patterns in Ventricular Paced Rhythms
- OMI Patterns: STEMI (-) Occlusion MI
- Opiate Toxicity
- orthodromic
- orthodromic SVT
- Osborn waves
- overdose
- p mitrale
- p pulmonale
- p waves
- P.E.
- PAC
- PAC’s
- Paced rhythms
- Pacemaker
- Pacemaker emergencies
- pacemaker malfunction
- Pacer
- palpitations
- Pauses and clumped beats
- PE
- PE vs. STEMI
- peaked P waves
- Pediatric ECG
- Pediatric ECG Interval Table
- Pediatrics
- Pericardial effusion
- Pericardial Tamponade
- Pericarditis
- pericarditis vs acs
- Pericarditis vs. STEMI
- Periodic paralysis
- Persistent juvenile T-wave pattern
- PFO
- PGY-2 (Intermediate) Resident Curriculum
- PGY-3 (Advanced) Resident Curriculum
- PGY1 Curriculum
- PJC
- PJCs
- PJTW
- plaque rupture
- plaque vulnerability
- PMVT
- Pokey T wave
- Polymorphic Ventricular Tachycardia
- Polymorphic VT
- Polyuria
- Poor R Wave Progression (PRWP) DDx
- Poor R-wave progression
- post arrest ECG
- post cardiac arrest ECGs
- post-arrest
- Post-Arrest ECG for Dysrhythmias
- Post-Arrest ECG for Ischemia
- Post-arrest NSTE-ACS
- Post-arrest STEMI
- post-cardiac arrest ecg
- post-mi pericarditis
- Post-Thrombolytic Reperfusion ECG Findings
- Posterior MI
- Posterior Occlusion MI
- POSTERIOR OMI
- Posterior STEMI
- Posterior STEMI Criteria
- postural orthostatic tachycardia syndrome
- Potpourri
- POTS
- PR interval
- PR segment
- PR Segment Basics
- PR segments
- Pre-hospital ECG
- precordial lead misplacement
- precordial swirl
- preexcitation
- preexcitation syndrome
- Preexcitation syndromes
- preexcited af
- preexcited atrial fibrillation
- Pregnancy
- Prehospital ECG
- premature atrial complexes
- Premature beats
- Premature complexes
- premature contractions
- premature junctional complexes
- Prolonged QT
- Prolonged QT interval
- prolonged QTc
- Proper 12-Lead ECG Electrode Placement
- Proper ECG Lead Placement
- proper lead placement
- proportionality
- PRWP
- Pseudo Wellens
- Pseudo-Wellens waves
- Pseudonormalization of T-waves
- Pulmonary Embolism
- pulmonary hypertension
- Pulse tapping artifact
- pulse-tapping
- PVC
- PVCs
- PVT
- Q-waves
- QRS
- QRS axis
- qrs axis basics
- QRS Complexes
- QRS fragmentation
- QRS Fragmentation (fQRS)
- QRS morphology
- qrs voltage
- QRS-interval
- QRS-T proportionality
- QT interval
- QT Interval Basics
- QTc interval
- R wave basics
- R waves
- R-on-T phenomenon
- R-wave
- R-wave in V1
- R-wave progression
- RAD
- RAE
- rapid af
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- rapid atrial fibrillation
- rate & rhythm
- RBBB
- Really wide complex tachycardia
- reciprocal changes
- Recommended ECG Books
- Reflux
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- repeat ecg
- repolarization abnormalities
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- Respiratory variation
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- Revised Sgarbossa Criteria
- Rhythm
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- right atrial enlargement
- Right axis
- Right Axis Deviation
- Right Axis Deviation + STE DDx
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- Right Axis Deviation Basics
- Right Axis Deviation DDx
- Right bundle branch block
- right heart strain
- Right sided leads
- Right Ventricular (RV) STEMI Criteria
- Right Ventricular Hypertrophy
- Rightward axis
- rollercoaster T waves
- RRWCT
- RV MI
- RV Outflow Tract Tachycardia (RVOT VT)
- RV Outflow Tract Tachycardia (RVOT)
- RV STEMI
- rvh
- RVH with strain
- RVMI
- RWCT
- S wave
- S waves
- s5
- SAH
- Salvador Dali
- SANRT
- SCAD
- second degree av block
- Second-Degree AV Block Type I (Mobitz I / Wenckebach)
- Second-Degree AV Block Type II (Mobitz II)
- Second-Degree AV Block with 2:1 Conduction
- segments
- Seizure
- Seizures
- Septal STEMI
- Serial ECG
- Serial ECGs
- Severe Hyperkalemia
- Severe Hypothermia
- Severe hypothyroidism
- Sgarbossa
- Sgarbossa Criteria
- Shark fin morphology
- Shark Fin or Triangular STEMI
- Shark fin STEMI
- Short PR interval
- Short QT
- Short QT interval
- Short QT Syndrome
- Short QTc
- Shortened QT
- SHS
- sick sinus syndrome
- Sinoatrial Exit Block
- Sinoatrial Nodal Reentry Tachycardia
- Sinoatrial Nodal Reentry Tachycardia (SANRT)
- Sinus arrest
- sinus arrhythmia
- sinus bradycardia
- sinus inversus totalis
- Sinus Node Dysfunction
- Sinus Node Dysfunction (Sick Sinus Syndrome
- sinus rhythm
- Sinus rhythms
- Sinus Tachycardia
- situs inversus
- situs inversus totalis
- Sloof Lirpa Sign
- Slow Atrial fibrillation
- slow ventricular tachycardia
- slow vt
- Sodium channel blocker toxicity
- South Africa
- South Africa sign
- South African
- South African Flag Sign
- spiked
- Spiked Helmet sign
- spiked-helmet
- Spodick Sign
- Spodick’s Sign
- Spontaneous Coronary Artery Dissection
- Spontaneous Coronary Artery Dissection (SCAD)
- ST
- ST depression
- ST depression differential
- ST Depression in V1-V4 DDx
- ST depression V1-V4
- ST Elevation
- ST Elevation DDx
- ST Elevation in aVR DDx
- ST segment elevation
- ST Segment Elevation in aVR with Multi Lead ST Segment Depression
- ST-segment
- ST-segment depression
- stat
- stat ecg
- stat ecgs
- STD
- STE
- STE differential diagnosis
- STE in aVR
- steeple sign
- Steeple sign in V1
- STEMI
- STEMI Criteria
- STEMI Criteria & STEMI Equivalent Patterns
- STEMI diagnosis
- STEMI equivalent
- STEMI equivalents
- STEMI mimics
- STEMI vs. acute pericarditis
- STEMI vs. Early repolarization
- STEMI vs. Severe Hyperkalemia
- stepwise approach
- strain
- Stress Testing
- Stress tests
- Student Level Curriculum
- Subtle ST elevation
- Subtle ST Segment Elevation (STE)
- subtle stemi
- Supraventricular tachycardia
- Supraventricular Tachycardia (SVT)
- Sustained VT
- SVT
- sympathomimetic
- synchronization
- Syncop
- Syncope
- syncope ddx
- syncope differentials
- syncope emergencies
- Systematic approach to ECG
- T wave
- T wave inversion differential
- T Wave Inversion in V1-V3 DDx
- T wave inversions in V1-V3
- T wave morphology
- T-wave abnormalities
- T-wave alternans
- T-wave inversion
- T-wave inversions
- T-waves
- Tachycardia
- Takotsubo Cardiomyopathy
- Takotsubo Cardiomyopathy vs. STEMI
- Tall R wave in aVR
- Tall R wave in V1
- Tamponade
- TCA
- TCA overdose
- TCA toxicity
- TdP
- Tension Pneumothorax
- Terminal QRS distortion
- Terminal QRS Distortion (OMI Pattern)
- the basics
- The Bix Rule
- The Bix Rule – Unmasking Atrial Flutter
- The Curriculum
- third degree AV block
- Third-Degree AV Block (Complete Heart Block)
- Thrombolytics
- tombstone
- tombstoning
- too many P waves
- Too Many P Waves (P:QRS>1) DDx
- Top 10 cases of the past 10 years
- Torsades
- Torsades de pointes
- Torsades de Pointes risk
- torsades de points
- Toxicologic Emergencies
- Toxicology
- TP segment
- Transient STEMI
- Tremor artifact
- trifascicular block
- Trigeminy
- Troponin
- troponins
- TWI
- Type A Wellens
- Type B Wellens
- U-waves
- Understanding ECG Artifacts
- unifascicular
- unstable angina
- unstable bradycardia
- unstable tachyarrhythmia
- unstable tachycardia
- Upright T waves in V1
- urgent cath
- V1
- v1-v2 placed too high
- V1/V2
- vasospasm
- Ventricular aneurysm
- Ventricular dysrhythmias
- ventricular escape rhythms
- Ventricular fibrillation
- ventricular fibrillation mimics
- Ventricular Flutter
- Ventricular rhythm
- Ventricular rhythms
- Ventricular Tachycardia
- Ventricular Tachycardia (VT)
- Ventricular tachycardia mimics
- Ventricular tachycardia vs. SVT with aberrant conduction
- Ventricular Tachycardiak
- Vereckei aVR
- VF
- voltage
- VT
- VT mimics
- VT vs. SVT with Aberrancy
- w Voltage
- waveforms
- waves
- WCT
- Wellens
- Wellens waves
- Wellens’ syndrome
- Wide & Regular Tachydysrhythmia DDx
- wide complex irregular tachycardia
- Wide complex QRS
- wide complex regular tachycardia
- Wide complex tachycardia
- Wide QRS
- Wide QRS (BBBs & Paced Rhythms) vs. STEMI
- wide qrs bradycardia
- Wide QRS Complex DDx
- wide qrs differential
- Wide QRS interval
- wide vs. narrow QRS
- Wolff Parkinson White
- Wolff-Parkinson White (WPW) Syndrome
- WPW
- wpw syndrome
- WPW syndrome and Pseudo-MI patterns
- WPW vs STEMI
- WPW with Antidromic SVT
- WPW with atrial fibrillation
- WPW with Orthodromic SVT
- WPW with SVT
- Yamaguchi
- Yamaguchi (Apical) Hypertrophic Cardiomyopathy
- Yamaguchi syndrome
- Young patients
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