Right Axis Deviation
Results:
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…
Navigating a Very Abnormal QRS Axis with a Stepwise Approach
A 44-year-old woman presents to the emergency department with vague complaints about shortness of breath. The following ECG is obtained at triage and brought to you for interpretation:
Right Axis Deviation + STE DDx
Key Points RAD + ST-Segment Elevation: When you encounter right axis deviation (RAD) combined with ST-segment elevation (STE) on an ECG, it’s crucial to consider differential diagnoses beyond STEMI, as…
Right Axis Deviation Basics
Key Points Definition: Right Axis Deviation (RAD) occurs when the QRS axis on an ECG is shifted rightward, typically between +90° and +180°. Common Causes: RAD is commonly associated with…
Interesting Cases from UMMC, Part II
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
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: must know causes of right axis deviation and wide QRS complexes
A 30-year-old man is pulled over by police for speeding. He begins feeling nauseous and has multiple episodes of vomiting. During transport to the emergency department by EMS he is…
STAT ECG Diagnoses: right ventricular hypertrophy criteria, electrical alternans vs. respiratory variation, and much more
An ill appearing patient arrives to the emergency department in extremis and history is limited. The following ECG is obtained:
UMEM cases that highlight the right way to think about new right axis deviation and much more!
An 87-year-old man is brought to the emergency department by EMS with acute chest pain. The following ECG is obtained on arrival:
Must know ECGs you will see on board exams and have to recognize in real life
A 34-year-old man is brought to the emergency department with delirium and agitation. 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:
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:
STAT ECG Diagnoses: causes of right axis deviation, and evaluation of ST segments in patient with right bundle branch block (RBBB)
An 80-year-old man presents to an emergency department in Chile with chest pain radiating to the right shoulder and back. The following ECG is obtained on arrival and computer interpreted…
STAT ECG Diagnoses: the right way to think about right axis deviation
A 91-year-old woman with PMHx of HTN, aortic stenosis, and dementia is brought to the ED by EMS after a syncopal episode when walking to the bathroom. Vital signs are…
Differential Diagnoses: important considerations in patients with new onset seizures or altered mental status, must know diagnoses in the emergency department
A 40-year-old man is brought into the ED after being found in the street and noted to have intermittent seizures. He is tachycardic, hypertensive, and febrile. The following ECG was…
ECG Basics and Fundamentals: right axis deviation differential and ST segment elevation in rightward leads
A 48-year-old woman presents to the ED with chest pain and near syncope. The following ECG is obtained:
STAT ECG Diagnoses: how to use ECG differentials to clinc the diagnosis in patients who are altered and can not provide a reliable history
A 50-year-old woman is found unconscious by a family member this morning. She was last known normal yesterday afternoon. On arrival to the ED she is minimally responsive and only…
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…
ECG Basics & Fundamentals: ECG findings of dextrocardia
A 22-year-old woman presents to the emergency department with atypical chest pain. Her vital signs are normal. The following ECG is obtained:
ECG Tags
- & Myocardial Ischemia
- 11th Annual UMEM ECG Competition
- 12th annual UMEM Residency ECG competition
- 1st degree AV Block
- 1st degree AVB
- 2:1 AV Block
- 2:1 AVB
- 2:1 Conduction
- 2015 ECG Competition
- 2015 ECG Competition Part II
- 2016 ECG Competition
- 2017 ECG Competition Part II
- 2018 ECG Competition Part II
- 2019 ECG Competition
- 2020 ECG Competition
- 2024 ECG Competition
- 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 Coronary Syndromes (ACS)
- Acute MI
- Acute Pericarditis
- Acute Pericarditis vs. STEMI
- Adenosine
- Adenosine sensitive VT
- Advanced AV block
- Afib
- Afib with WPW
- AI
- AI interpreted ECGs
- AIVR
- Altered Mental Status Emergencies
- AMI
- Amiodarone
- Anemia
- Anterior STEMI
- antidromic
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- Aortic Dissection
- Approach to ECG
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- Appropriate Discordance
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- Arrhythmogenic right ventricular cardiomyopathy
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- Arrhythmogenic RV Dysplasia
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- ASD
- Ashman
- Ashman phenomenon
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- Aslanger Pattern
- Aslanger's Pattern
- 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 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
- AV Block
- AV Blocks
- AV Dissociation
- AV dissociation without complete heart block
- AVB
- AVB: 1st degree
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- AVD
- aVL
- AVNRT
- aVR
- Axis
- axis basics
- Barcelona criteria
- Basics
- basics and fundamentals
- BBB
- 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
- BRASH syndrome
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- Brugada Pattern
- Brugada syndrome
- Buried P Waves
- CAD
- cannabis
- cannabis toxicity
- Cardiac arrest
- cardiac risk factors
- Cardiac tamponade
- Cardiovascular effects of marijuana
- Cardioversion
- CCB toxicity
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- CHB
- Chemotherapy
- Chest Pain
- Classic STEMI Criteria
- clumped beats
- cocaine
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- Complete Heart Block
- Computer ECG interpretation
- Computer interpreted ECGs
- Computer interpreted electrocardiograms
- congenital long QT syndrome
- congenital short QT syndrome
- coronary angiography
- COVID-19
- Crochetage
- Crochetage pattern
- ddx
- de Winter T-wave
- de Winter T-waves
- 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
- digoxin
- Digoxin effect
- Digoxin toxicity
- DKA
- Dominant R wave
- Dominant R wave in aVR
- Dominant R wave in V1
- Dysrhythmia
- Dysrhythmia in LVADs
- Dysrhythmias
- Earliest ECG Evidence of Occlusion MI
- Early cardiac ischemia
- Early ECG evidence of ischemia
- Early ischemia
- Early ischemic changes
- Early reciprocal changes
- Early Repolarization
- early repolarization vs/ STEMI
- early signs of cardiac ischemia
- early signs of ischemia
- ecg 101
- ECG Basics
- ECG competition
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- ecg history
- ECG interruptions
- Ectopic atrial rhythm
- Ectopic beats
- electrical alternans
- Electrical storm
- Electrocardiographic polyuria
- Electrographic polyuria
- Electrolytes
- Elevated intracranial pressure
- Emergent cath lab activation
- EMS
- EMS cases
- Epsilon waves
- escape rhythm
- evolution of ecg
- Evolving STEMI
- extreme axis deviation
- Fascicular blocks
- fever
- Flattened T Waves
- Flutter Waves (F waves)
- Fusion Beats
- GERD
- grouped beats
- Guidelines
- Heart block
- heart rate
- heart rate and rhythm basics
- heart rate basics
- heart rhythm
- heart rhythm interpretation
- High grade AV block
- high grade AV blocks
- high lateral STEMI
- high risk pe
- High Voltage
- high-risk pulmonary embolism
- Himalayan T-waves
- history of ecg
- History of presenting illness
- HOCM
- Hypeacute T waves
- Hyperacute T-waves
- Hypercalcemia
- Hyperkalemia
- hyperkalemia mimics
- Hyperkalemic Periodic Paralysis
- Hypermagnesemia
- Hypertrophic Cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Hypocalcemia
- Hypokalemia
- Hypomagnesemia
- hyponatremia
- Hypothermia
- Idioventricular rhythms
- Impressive syndrome
- inappropriate sinus tachycardia
- incomplete right bundle branch block
- indeterminate axis
- indeterminate QRS axis
- inferior STEMI
- intermittent
- Intermittent WPW
- intervals
- Intracranial hemorrhage
- Intractable chest pain
- inverted P Waves
- Inverted T Waves
- Inverted U-waves
- IRBBB
- Irregular rhythm
- irregular rhythms
- Ischemia
- Ischemic T-waves
- Isoelectric baseline
- Isoelectric segment
- Isoelectric Segment of the ECG
- Isolated Posterior STEMI
- Isorhythmic AV dissociation
- Isorhythmic AVD
- J point
- J wave
- J-waves
- Jervell
- Jervell and Lange-Nielsen Syndrome
- JLNS
- junctional escape rhythms
- junctional rhythm
- Junctional rhythms
- Junctional Tachycardia
- Juvenile T wave inversions
- Juvenile T-wave pattern
- killer differentials
- LAD
- LAFB
- Lange
- 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)
- 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 QRS
- Low Voltage QRS DDx
- LPFB
- LQT1 (KCNQ1 Mutation)
- LQT2 (KCNH2 Mutation)
- LQT3 (SCN5A Mutation)
- LQTS
- LV Aneurysm
- LV Aneurysm vs. STEMI
- LVAD
- LVAD Dysrhythmias
- LVADs
- LVH
- LVH vs. STEMI
- LVH with strain pattern
- Lyme carditis
- Marijuana
- marijuana toxicity
- Massive STEMI
- MAT
- Mechanisms of ACS
- Metabolic Emergencies
- Methamphetamine Toxicity
- MI
- mimics
- misplaced leads
- Mobitz
- Mobitz conduction
- Mobitz I
- Mobitz I (Wenckebach)
- Mobitz II
- Mobitz II (Hay)
- Mobitz II AV block
- Modified Sgarbossa criteria
- Monomorphic Ventricular Tachycardia
- monomorphic VT
- Multifocal atrial tachycardia
- Myocarditis
- Myxedema
- Na channel blocker toxicity
- narrow & irregular tachycardia
- narrow & regular tachycardia
- Narrow complex and regular rhythms
- Narrow complex irregular rhythms
- Narrow complex irregular tachycardia
- Narrow Complex Regular Tachycardia
- Narrow Complex Tachycardia
- narrow qrs bradycardia
- 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
- OMI
- 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
- PAC
- PAC’s
- Paced rhythms
- Pacemaker
- Pacer
- palpitations
- Pauses and clumped beats
- PE
- PE vs. STEMI
- peaked P waves
- Pediatric ECG
- Pediatric ECG Interval Table
- Pediatrics
- Pericardial effusion
- Pericardial Tamponade
- Pericarditis
- Pericarditis vs. STEMI
- Periodic paralysis
- Persistent juvenile T-wave pattern
- PFO
- PJC
- plaque rupture
- plaque vulnerability
- Polymorphic Ventricular Tachycardia
- Polymorphic VT
- Polyuria
- Poor R-wave progression
- post arrest ECG
- post cardiac arrest ECGs
- post-arrest
- Post-arrest NSTE-ACS
- Post-arrest STEMI
- post-cardiac arrest ecg
- Post-Thrombolytic Reperfusion ECG Findings
- Posterior MI
- Posterior STEMI
- Posterior STEMI Criteria
- postural orthostatic tachycardia syndrome
- Potpourri
- POTS
- PR interval
- PR segment
- PR segments
- Pre-hospital ECG
- precordial lead misplacement
- preexcitation
- preexcitation syndrome
- Preexcitation syndromes
- preexcited af
- preexcited atrial fibrillation
- Pregnancy
- Prehospital ECG
- premature atrial complexes
- Premature beats
- Premature complexes
- premature contractions
- premature junctional complexes
- Prolonged QT
- Prolonged QT interval
- prolonged QTc
- proper lead placement
- proportionality
- PRWP
- Pseudo Wellens
- Pseudo-Wellens waves
- Pseudonormalization of T-waves
- Pulmonary Embolism
- pulmonary hypertension
- PVC
- PVCs
- PVT
- Q-waves
- QRS
- QRS axis
- qrs axis basics
- QRS Complexes
- QRS fragmentation
- QRS Fragmentation (fQRS)
- QRS morphology
- qrs voltage
- QRS-interval
- QRS-T proportionality
- R wave basics
- R waves
- R-on-T phenomenon
- R-wave
- R-wave in V1
- R-wave progression
- RAD
- rapid af
- rapid afib
- rapid atrial fibrillation
- rate & rhythm
- RBBB
- Really wide complex tachycardia
- reciprocal changes
- Reflux
- Regular Really Wide Complex Tachycardia
- Regular Rhythm
- Regular Wide Complex Tachycardia
- Regularized atrial fibrillation
- repolarization abnormalities
- Rescue PCI
- Resolved ST segment elevation
- Resources & Recommendations
- Respiratory variation
- Retrograde P waves
- Reverse R wave progression
- 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
- RVMI
- RWCT
- S wave
- S waves
- SAH
- Salvador Dali
- SANRT
- segments
- Seizure
- Seizures
- Septal STEMI
- Serial ECG
- Serial ECGs
- Severe hypothyroidism
- Sgarbossa
- Sgarbossa Criteria
- Shark fin morphology
- Shark fin STEMI
- Short PR interval
- Short QT
- Short QT interval
- Short QT Syndrome
- Short QTc
- 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 sign
- Spiked Helmet sign
- Spodick Sign
- Spodick’s Sign
- ST
- ST depression
- ST depression V1-V4
- ST Elevation
- ST Elevation DDx
- ST Elevation in aVR DDx
- ST segment elevation
- ST Segment Elevation in aVR with Multi Lead ST Segment Depression
- ST-segment
- ST-segment depression
- stat
- stat ecg
- stat ecgs
- STD
- STE
- STE in aVR
- STEMI
- STEMI Criteria
- STEMI equivalent
- STEMI equivalents
- STEMI mimics
- STEMI vs. acute pericarditis
- STEMI vs. Early repolarization
- stepwise approach
- strain
- Stress Testing
- Stress tests
- Subtle ST Segment Elevation (STE)
- Supraventricular tachycardia
- Supraventricular Tachycardia (SVT)
- Sustained VT
- SVT
- Syncop
- Syncope
- syncope ddx
- syncope emergencies
- Systematic approach to ECG
- T wave inversion differential
- T Wave Inversion in V1-V3 DDx
- 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
- TCA toxicity
- Terminal QRS distortion
- the basics
- Thrombolytics
- too many P waves
- Torsades
- Torsades de pointes
- torsades de points
- Toxicologic Emergencies
- Toxicology
- TP segment
- Transient STEMI
- Tremor artifact
- trifascicular block
- Trigeminy
- Troponin
- TWI
- Type A Wellens
- Type B Wellens
- U-waves
- unifascicular
- unstable bradycardia
- unstable tachyarrhythmia
- unstable tachycardia
- 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)
- Ventricular tachycardia mimics
- Ventricular tachycardia vs. SVT with aberrant conduction
- Ventricular Tachycardiak
- VF
- voltage
- VT
- VT mimics
- w Voltage
- waveforms
- waves
- WCT
- Wellens
- Wellens waves
- Wellens’ syndrome
- 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
- 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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