PAC’s
Results:
Premature Atrial Complexes (PACs)
Key Points Origin and Characteristics: PACs originate from ectopic atrial foci, resulting in abnormal P waves with different morphology and axis compared to sinus P waves. Hidden P Waves: Ectopic…
Premature Complexes (PACs, PJCs, & PVCs)
Key Points Spontaneous Depolarization: Different pacemaker cells in the heart can spontaneously depolarize at varying rates; the SA node is usually the fastest. Ectopic Impulses: Early depolarizations from ectopic foci…
How to avoid misdiagnosis of irregular rhythms
A 80-year-old woman is referred to the emergency department for suspected rapid atrial fibrillation. The following ECG is obtained on arrival:
ECG Basics and Fundamentals: causes of pauses or clumped/grouped beats on the ECG
A 72-year-old man with PMHx of HTN presents to the emergency department with vomiting and lightheadedness. He is noted to be slightly bradycardic with an irregular rhythm on arrival. The…
Bradydysrhythmia: An irregular rhythm with grouped or clumped beats
A 75-year-old woman presents to the emergency department with palpitations and near syncope. She is noted to be bradycardic with an irregular rhythm. The following ECG is obtained on arrival:
Bradydysrhythmia: when is it actually considered a complete heart block?
A 52-year-old man presents to the emergency department with chest pain associated with nausea and diaphoresis. The following ECG is obtained on arrival:
Bradyarrhythmias: the types of acute myocardial infarction associated with heart block
A 48-year-old woman presents to the emergency department with a 2-day history of intermittent neck pain associated with nausea. Her pain progressively worsened and is now persistent. The following ECG…
Differential DIagnoses: AV blocks, prolonged QTc intervals, T wave inversions, and more!
A 50-year-old woman is brought into the emergency department unresponsive. History is otherwise limited. The following ECG is obtained with no prior ECGs available for comparison:
Rhythm Interpretation: never trust the computer interpretation and scrutinize every lead
An elderly male presents with weakness and lightheadedness to his primary care physician. He is referred to the ED after the following ECG is obtained:
Rhythm Interpretation: grouped or clumped beats
A 67-year-old male with PMHx of ESRD presents to the ED with fevers and bacteremia. The following ECG is obtained for mild tachycardia:
Rhythm Interpretation: how to avoid misdiagnosis of atrial fibrillation
An elderly male presents to the ED after a syncopal episode. He is found to be weak and lightheaded on arrival, with hypotension and mild tachycardia. There is no evidence…
Bradydysrhythmias: a differential for too many P waves and a lesson in how to break down difficult rhythms
An 81-year-old female presents to the ED with lightheadedness and “funny heart beats”. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is…
Narrow Complex Tachycardia: inappropriate anticoagulation because of misdiagnosis
A 96-year-old man presents to the ED with a dry skin rash. On review of symptoms the patient reports 1-2 episodes of fleeting chest pain that is sharp. The following…
Differential Diagnoses: Non-conducted P-waves (P:QRS > 1)
HPI: A 92-year-old woman presents to the emergency department with lightheadedness. Case ECG Before watching this week’s video, ask yourself these questions: Focus on the rate and rhythm, what…
Rhythm Interpretation: a three-step approach to diagnosing AV blocks
HPI: A 54-year-old woman with PMHx of cardiomyopathy is referred to the ED by her cardiologist who is concerned about an “arrhythmia”. Case ECG Before watching this week’s video,…
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