Pulmonary Embolism
Results:
ECG Hallucinations: When S1Q3T3 Misleads
A 51-year-old truck driver presents to the ED after a brief syncopal episode at a rest stop. It is the middle of summer, his truck’s air conditioning is not working,…
S1Q3T3 Pattern
Key Points: Not a PE diagnosis: S1Q3T3 is classically associated with pulmonary embolism, but it is neither sensitive nor specific enough to diagnose or exclude PE. Think acute right heart…
ECG in Pulmonary Embolism (PE)
Key Points: The ECG cannot rule in or rule out PE: No single ECG finding is sufficiently sensitive or specific to diagnose or exclude acute pulmonary embolism. A Normal ECG…
High Risk Pulmonary Embolism (PE)
Key Points: The ECG can provide an early warning of severe RV strain: No ECG finding defines high risk PE, but marked or evolving signs of acute RV pressure overload…
Optical Illusions and 12-Lead ECGs: How First Impressions Can Mislead
A 42-year-old woman presents to the emergency department with chest pain, shortness of breath, and palpitations. Her blood pressure and mental status are noted to be normal. The following ECG…
When ST Elevation Isn’t What It Seems
A 30-year-old man with a history of coronary artery disease and heart failure with reduced ejection fraction (HFrEF) presents to the emergency department with acute chest pain and shortness of…
Recent UMMC Cases
A 67 -year-old man presents to a busy emergency department with acute chest pain and shortness of breath. The following ECG is obtained, but he leaves without being seen because…
Interesting Cases from UMMC (2024 – Part II/III)
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
2024 EM Boards ECG Review (Part I/II)
A 61-year-old man with a history of atrial fibrillation presents to ABEM general hospital with lightheadedness and palpitations. He is tachycardic but otherwise has normal vital signs. The following ECG…
STAT ECG Diagnoses: recognition of life threatening ECG patterns before sudden cardiac arrest
A 73-year-old woman with past medical history of diabetes mellitus and atrial fibrillation is brought to the emergency department for mild hematemesis. The following ECG is obtained, and the patient…
Differential Diagnoses: killer causes of T wave inversions that you gotta know!
A 48-year-old man presents to the emergency department with chest pain and shortness of breath. The following ECG is obtained on arrival:
Bradydysrhythmia: Does this patient need a permanent pacemaker?
A 63-year-old man presents to the emergency department with lightheadedness. He is noted to be bradycardic on arrival. The following ECG is obtained:
STAT ECG Diagnoses: the differentials to consider when dealing with ST segment elevation and an impressive syndrome
A 61-year-old woman presents the ED for evaluation of a possible acute stroke. She woke up unable to walk due to bilateral lower extremity weakness and is now also feeling…
Potpourri of cases: the most common ECG findings in pulmonary embolism, electrical alternans, and so much more!
A 72-year-old woman presents the ED with atypical chest pain. She is found to be mildly tachycardic. The following ECG is obtained:
Differential Diagnoses: the many causes of ST segment elevation
A 69-year-old woman presents to the ED with chest pain and shortness of breath. The following ECG is obtained:
STAT ECG Diagnoses: a patient transferred for suspected STEMI, what other etiologies could be causing this ST segment elevation?
A 24-year-old male with past medical history of paraplegia from severe multiple sclerosis is transferred from a nursing home for suspected STEMI. Transfer documentation reports a history of pleuritic chest…
2019 ECG Competition Answers (Part 2/3)
This week we review the answers to questions 7-11, & 13 from the 7th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…
EMS ECGs: S1Q3T3, is it pathognomonic for acute pulmonary embolism
A 63-year-old woman presents to the emergency department with palpitations. The following ECG was obtained by EMS prior to arrival:
Differential Diagnoses: when STEMIs can present with right axis deviation
HPI: A 57-year-old with PMHx of HTN and cigarette smoking presents to the ED with chest pain and dyspnea. The following ECG is obtained: Case ECG Before watching this week’s…
Differential Diagnoses: considerations in patients with right axis deviation (RAD) and T wave inversions
HPI: An 86-year-old male with PMHx of MI, HTN, HLD, COPD, and CVA presents with abrupt onset chest pain, dyspnea, and nausea. Pain started a few hours ago, is non-radiating,…
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