Limb lead reversal
Results:
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:
Potpourri of cases: generic polymorphic ventricular tachycardia vs. torsades de pointes, regularized atrial fibrillation, and much more!
A 60-year-old man presents to the emergency department with generalized weakness and intermittent palpitations. Vital signs are normal on arrival. The following ECG is obtained during an episode of palpitations:
Potpourri of cases: differential diagnoses for long QTc intervals, diagnosing occlusion MI in LBBB and paced rhythms, and so much more!
A 48-year-old woman is brought into the emergency department with fever and altered mental status. The following ECG is obtained on arrival:
ECG Tags
- & Myocardial Ischemia
- 11th Annual UMEM ECG Competition
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- 1st degree AV Block
- 1st degree AVB
- 2:1 AV Block
- 2:1 AVB
- 2:1 Conduction
- 2015 ECG Competition
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- 3rd degree AV block
- 5 Step Approach
- 5-FU
- aberrancy
- Aberrant conduction
- Abnormal ECG
- Abnormal P wave Axis DDx
- absent p waves
- Accelerated idioventricular rhythm
- accelerated junctional rhythm
- Acidosis
- ACS
- ACS mimics
- ACS RIsk Factors
- Acute Chest Pain
- Acute Chest Pain DDx
- Acute Coronary Syndromes (ACS)
- Acute MI
- Acute Pericarditis
- Acute Pericarditis vs. STEMI
- Adenosine
- Adenosine sensitive VT
- Advanced AV block
- Afib
- Afib with WPW
- AI
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- AIVR
- Algorithm Limitations
- Altered Mental Status Emergencies
- AMI
- Amiodarone
- and Lead II R-wave-peak-time (RWPT) algorithms
- Anemia
- Anterior STEMI
- Anterior T wave inversions
- antidromic
- antidromic SVT
- Aortic Dissection
- Approach to ECG
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- Appropriate Discordance
- April Fools
- arrhythmogenic cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy
- Arrhythmogenic right ventricular dysplasia/cardiomyopathy
- Arrhythmogenic RV Dysplasia
- Artifact
- artifact vs. malignant arrhythmias
- artifact vs. torsades
- artifact vs. ventricular fibrillation
- Artifact vs. ventricular rhythm
- artifact vs. ventricular tachycardia
- Artificial Intelligence
- ARVC
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- Ashman
- Ashman phenomenon
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- Atherosclerosis
- Athlete’s ECG
- atrial arrhythmias
- Atrial dysrhythmias
- Atrial fibrillation
- Atrial Fibrillation (AFib)
- atrial fibrillation with complete heart block
- Atrial Fibrillation with RVR
- Atrial Fibrillation with SVT
- Atrial Fibrillation with WPW
- 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
- Atrioventricular Reciprocating Tachycardia
- Attending Level Curriculum
- AV Block
- AV Block: Second-Degree
- AV Blocks
- AV Dissociation
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- AVD
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- Bayesian
- Bazett formula
- BBB
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- Benign early repolarization
- BER
- Beta-Blocker (BB) and Calcium Channel Blocker (CCB) Toxicity
- bidirectional ventricular tachycardia
- bifascicular block
- bifid p waves
- bigeminy
- Biphasic T-waves
- Bix rule
- Bizzare rhythm
- Blocked PAC’s
- Board review
- bpm
- brady
- brady tachy syndrome
- bradyarrhythmia
- Bradycardia
- Bradycardia DDx
- BRASH syndrome
- Brs
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- Brugada Pattern
- Brugada Sign
- Brugada syndrome
- Brugada Syndrome (BrS)
- Buried P Waves
- Buried T wave
- CAD
- cannabis
- cannabis toxicity
- Cardiac arrest
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- cardiogenic shock
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- Cardioversion
- Catecholaminergic Polymorphic VT (CPVT)
- CCB toxicity
- Cerebral T waves
- CHB
- Chemotherapy
- Chest Pain
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- child
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- Classic STEMI Criteria
- clumped beats
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- cocaine
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- congenital long QT syndrome
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- coronary angiography
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- COVID-19
- Crochetage
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- 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
- Dysrhythmia
- Dysrhythmia in LVADs
- Dysrhythmias
- Earliest ECG Evidence of Occlusion MI
- Early cardiac ischemia
- Early ECG evidence of ischemia
- Early ischemia
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- Early reciprocal changes
- Early Repolarization
- early repolarization vs/ STEMI
- early signs of cardiac ischemia
- early signs of ischemia
- Early STEMI
- ecg 101
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- Epsilon waves
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- evolution of ecg
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- extreme axis deviation
- failure to capture
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- failure to sense
- Fascicular blocks
- fever
- Flattened T Waves
- Flutter Waves (F waves)
- Foundational Resident
- Framingham formula
- Fridericia formula
- Fusion Beats
- generic PMVT
- GERD
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- 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
- Idioventricular rhythms
- Impressive syndrome
- in-training exam
- inappropriate sinus tachycardia
- incomplete right bundle branch block
- indeterminate axis
- 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 wave
- J-waves
- Jervell
- Jervell and Lange-Nielsen Syndrome
- JLNS
- Josephson Sign
- Josephson’s sign
- junctional escape rhythms
- junctional rhythm
- Junctional rhythms
- Junctional Tachycardia
- Juvenile T wave inversions
- Juvenile T waves
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- kid
- kid ecg
- kids
- killer differentials
- LAD
- LAFB
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- Large T Wave DDx
- Large T-waves
- LBBB
- LBBB DDx
- lead misplacement
- lead V1
- left anterior fascicular block
- 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
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- LVADs
- LVH
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- LVH with strain pattern
- Lyme carditis
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- Massive STEMI
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- Mechanisms of ACS
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- MI
- mimics
- misplaced leads
- Mobitz
- Mobitz conduction
- Mobitz I
- Mobitz I (Wenckebach)
- Mobitz II
- Mobitz II (Hay)
- Mobitz II AV block
- modified lead
- Modified Sgarbossa criteria
- Monomorphic Ventricular Tachycardia
- monomorphic VT
- Multifocal atrial tachycardia
- Myocarditis
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- Na channel blocker toxicity
- narrow & irregular tachycardia
- narrow & regular tachycardia
- Narrow complex and regular rhythms
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- Narrow complex irregular tachycardia
- Narrow Complex Regular Tachycardia
- narrow complex regular tachycardia differential
- Narrow Complex Tachycardia
- narrow qrs bradycardia
- New Q Waves
- New RBBB and LAFB
- Nielsen
- Nikelekam T-waves
- No clear P waves DDx
- Non-conducted P wave (P:QRS>1) DDx
- non-conducted PACs
- Non-STE ACS
- Non-sustained Ventricular tachycardia
- Non-sustained VT
- Nonspecific intraventricular conduction delay
- 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
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- Pacemaker
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- PE
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- peaked P waves
- Pediatric ECG
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- 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
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- PMVT
- Pokey T wave
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- Polymorphic VT
- Polyuria
- Poor R-wave progression
- post arrest ECG
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- post-mi pericarditis
- Post-Thrombolytic Reperfusion ECG Findings
- Posterior MI
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- POSTERIOR OMI
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- postural orthostatic tachycardia syndrome
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- R-wave
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- R-wave progression
- RAD
- rapid af
- rapid afib
- rapid atrial fibrillation
- rate & rhythm
- RBBB
- Really wide complex tachycardia
- reciprocal changes
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- Reflux
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- Regularized atrial fibrillation
- Regularly Irregular Rhythm
- repolarization abnormalities
- Rescue PCI
- Resolved ST segment elevation
- Resources & Recommendations
- Respiratory variation
- Retrograde P waves
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- Revised Sgarbossa Criteria
- Rhythm
- Rhythm Interpretation
- right atrial enlargement
- Right axis
- Right Axis Deviation
- 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)
- RV STEMI
- rvh
- RVH with strain
- RVMI
- RWCT
- S wave
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- SCAD
- segments
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- Shark fin morphology
- 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 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
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- ST segment elevation
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- ST-segment
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- stat
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- STEMI
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- STEMI vs. acute pericarditis
- STEMI vs. Early repolarization
- stepwise approach
- strain
- Stress Testing
- Stress tests
- Student Level Curriculum
- Subtle ST elevation
- Subtle ST Segment Elevation (STE)
- Supraventricular tachycardia
- Supraventricular Tachycardia (SVT)
- Sustained VT
- SVT
- synchronization
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- 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
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- TdP
- Terminal QRS distortion
- Terminal QRS Distortion (OMI Pattern)
- the basics
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- third degree AV block
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- unifascicular
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- Upright T waves in V1
- 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)
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- voltage
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- w Voltage
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- waves
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- Wellens’ syndrome
- Wide & Regular Tachydysrhythmia DDx
- wide complex irregular tachycardia
- Wide complex QRS
- wide complex regular tachycardia
- Wide complex tachycardia
- Wide QRS
- wide qrs bradycardia
- 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
- Young patients
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