Limb lead reversal
Results:
Bradycardia, STEMI, and a Misleading Rhythm Diagnosis
A 68-year-old woman calls EMS after having a syncopal episode while using the bathroom. She reports associated chest pain over the past day. The following prehospital ECG is obtained:
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:
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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- 2025 ACC/AHA/ACEP/NAEMSP/SCAI Clinical Practice Guidelines for the Management of Patients with Acute Coronary Syndromes
- 2025 ACS guidelines
- 3rd degree AV block
- 5 Step Approach
- 5-FU
- aberrancy
- Aberrant conduction
- Abnormal ECG
- Abnormal P wave Axis DDx
- Abnormal STAT ECG
- 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
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- Acute Pericarditis vs. STEMI
- Adenosine
- Adenosine sensitive VT
- Advanced AV block
- Afib
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- AMI
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- and Lead II R-wave-peak-time (RWPT) algorithms
- Anemia
- anemia in ACS
- Anterior STEMI
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- 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
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- artifact vs. ventricular tachycardia
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- atrial fibrillation with complete heart block
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- Atrial Fibrillation with SVT
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- Atrial flitter
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- 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
- AV Block: Second-Degree
- AV Blocks
- AV Dissociation
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- AVBs
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- bidirectional ventricular tachycardia
- bifascicular block
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- Board review
- bpm
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- COPD
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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
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- Digoxin toxicity
- DKA
- Dominant R wave
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- dresslers
- dresslers syndrome
- dynamic ecg changes
- Dysrhythmia
- Dysrhythmia in LVADs
- Dysrhythmias
- Earliest ECG Evidence of Occlusion MI
- Earliest Evidence of Occlusion MI
- Early cardiac ischemia
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- early repolarization vs/ STEMI
- early signs of cardiac ischemia
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- Early STEMI
- ecg 101
- ECG Basics
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- ECG Evidence of Reperfusion After Occlusion
- ecg history
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- Epsilon waves
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- evolution of ecg
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- 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
- fever
- First-Degree AV Block
- Flattened T Waves
- Flutter Waves (F waves)
- Foundational Resident
- Framingham formula
- Fridericia formula
- Fusion Beats
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- Griffith
- grouped beats
- Guidelines
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- heart rate and rhythm basics
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- heart rhythm
- heart rhythm interpretation
- High grade AV block
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- 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
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- hyperacute
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- Hypercalcemia
- Hyperkalemia
- Hyperkalemia emergencies
- hyperkalemia mimics
- Hyperkalemia vs. STEMI
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- Hyperkalemic paralysis
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- Hypermagnesemia
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- Hypocalcemia
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- 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 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 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
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- Junctional Tachycardia
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- kid
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- LAD
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- LAE
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- 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
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- long ST segment
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- Low voltage QRS
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- LPFB
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- LQTS
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- LVAD
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- misplaced leads
- Mobitz
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- 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 VT
- Multifocal atrial tachycardia
- Myocarditis
- Myxedema
- Na channel blocker toxicity
- narrow & irregular tachycardia
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- narrow complex regular tachycardia differential
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- 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
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- Osborn waves
- overdose
- p mitrale
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- peaked P waves
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- 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
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- plaque rupture
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- Prehospital ECG
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- Premature beats
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- premature contractions
- premature junctional complexes
- Prolonged QT
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- prolonged QTc
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- Rhythm
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- right atrial enlargement
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- rvh
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- RVMI
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- Second-Degree AV Block with 2:1 Conduction
- segments
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- SHS
- sick sinus syndrome
- Sinoatrial Exit Block
- Sinoatrial Nodal Reentry Tachycardia
- Sinoatrial Nodal Reentry Tachycardia (SANRT)
- Sinus arrest
- sinus arrhythmia
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- sinus inversus totalis
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- Sinus Node Dysfunction (Sick Sinus Syndrome
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- South Africa sign
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- spiked
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- Spontaneous Coronary Artery Dissection
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- ST
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- 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
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- ST-segment
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- stat
- stat ecg
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- STD
- STE
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- STE in aVR
- steeple sign
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- STEMI
- STEMI Criteria
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- stepwise approach
- strain
- Stress Testing
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- synchronization
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- 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
- The Bix Rule
- The Bix Rule – Unmasking Atrial Flutter
- The Curriculum
- third degree AV block
- Third-Degree AV Block (Complete Heart Block)
- Thrombolytics
- too many P waves
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- unifascicular
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- urgent cath
- V1
- v1-v2 placed too high
- V1/V2
- vasospasm
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- 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
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- VF
- voltage
- VT
- VT mimics
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- w Voltage
- waveforms
- waves
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- Wellens
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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 (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
- Young patients
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