Mimics

ECG STAT November 24, 2025

Pulse-Tapping Artifact

Key Points Mechanical artifact caused by an ECG electrode sitting on top of a strong arterial pulse. Seen frequently in dialysis patients with AV fistulas. Can mimic serious pathology including…

ECG STAT November 20, 2025

Key Points Definition: ST elevation refers to upward displacement of the ST segment above baseline, often signaling acute myocardial injury. Clinical Importance: While most concerning for STEMI due to acute…

ECG STAT October 25, 2025

Ventricular Tachycardia (VT) Mimics

Key Points: Initial Assumption: Any wide (QRS >120 ms), regular tachycardia should be considered ventricular tachycardia (VT) until clearly proven otherwise. VT Characteristics: VT generally has a ventricular rate of…

ECG STAT September 18, 2025

STEMI Mimics: DDx

Key Points Context Matters: ECGs must be interpreted in the clinical setting. Chest pain, shock, or ACS risk factors increase pretest probability of STEMI/OMI, while atypical presentations lower it. Prevalence:…

ECG STAT September 1, 2025

Wide & Regular Tachydysrhythmia DDx

Key Points Definition: Wide complex tachycardia (WCT) = QRS >120 ms with a steady R-R interval. This section focuses on regular WCT (RWCT). Wide & irregular rhythms are covered separately…

ECG STAT August 25, 2025

ST Elevation in aVR: DDx

Key Points Global Subendocardial Ischemia: ST elevation (STE) in aVR with diffuse ST depression elsewhere usually reflects global subendocardial ischemia. Proximal Occlusion or Severe CAD: Common in left main (LMCA)…

ECG STAT August 25, 2025

Takotsubo Cardiomyopathy vs STEMI: DDx

Key Points Takotsubo (stress) cardiomyopathy is a transient, non-ischemic LV dysfunction—classically apical ballooning with basal hyperkinesis—often after emotional or physical stress. Presentation mimics occlusion MI (chest pain, ECG changes, elevated…

ECG STAT August 20, 2025

Wide QRS Complex: DDx

Key Points A QRS duration greater than 120 ms indicates abnormal ventricular depolarization. A wide QRS can signal conditions that range from benign to immediately life-threatening. Developing a focused differential…

ECG STAT August 15, 2025

VT vs SVT with Aberrancy: DDx

Key Points ECG alone cannot reliably distinguish VT from SVT-aberrancy in many cases. Use ECG features to rule in VT, not to exclude it. Default: treat regular WCT as VT…

ECG STAT August 14, 2025

Understanding ECG Artifacts

Key Points Artifacts = non-cardiac signals that distort or obscure true ECG. They come from the patient, leads/equipment, or the environment. Clues to artifact: lacks a physiologic pattern, varies beat-to-beat…

ECG STAT August 1, 2025

Slow Ventricular Tachycardia (VT)

Key Points Definition: Slow ventricular tachycardia is defined as a wide complex tachycardia with a ventricular rate between 100–120 bpm. Distinction: Typical sustained VT usually exceeds 120 bpm. When encountering…

ECG STAT July 17, 2025

Terminal QRS Distortion: OMI Pattern

Key Points What it is: In V2 or V3, there is no S wave (the R does not descend below the PQ baseline) and no J wave (no notch/slur at…

ECG STAT July 14, 2025

LV Aneurysm vs STEMI: DDx

Key Points Left Ventricular Aneurysm (LVA): Causes persistent ST elevation lasting more than 2 weeks post-MI, typically seen in the anterior leads but can also affect the inferior leads. Occurs…

ECG STAT November 29, 2024

WPW Syndrome and Pseudo-MI Patterns

Key Points WPW Pattern Mimics: Wolff-Parkinson-White (WPW) syndrome can produce an ECG pattern that mimics conditions such as myocardial infarction, ventricular bigeminy, accelerated idioventricular rhythm, and electrical alternans. ST Segment…

ECG STAT November 14, 2024

LVH vs STEMI: DDx

Key Points LVH Mimicry: Left ventricular hypertrophy (LVH) can mimic anterior coronary occlusion and is a common cause of “false-positive” cath lab activations. Diagnostic Challenge: LVH with strain pattern can…

Weekly Workout June 17, 2024

Shock first and ask questions later?

An elderly woman with a past medical history of hypertension, diabetes, and Parkinson’s disease presents to the ED with hip pain after a fall. Her blood pressure and mental status…

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