Serial ECG
Results:
Literature Review: subtle early signs of cardiac ischemia and the value of serial ECGs in patients being evaluated for acute coronary syndromes (ACS)
A 47-year-old man is brought to the ED by EMS for acute onset left sided chest pain. The history is concerning for an acute coronary syndrome. The following ECG was…
ECG Basics and Fundamentals: how many STEMI patients present with nondiagnostic initial ECGs?
HPI: A 52-year-old male with PMHx of HTN & HLD presents to the ED with chest pain and shortness of breath. He looks uncomfortable on exam and is hypertensive. The…
How serial ECGs can save lives!
A 49-year-old man is brought in by EMS to the ED with chest pain concerning for cardiac ischemia. The following prehospital ECG was obtained:
Literature Review: outcomes for patients with STEMI presenting with nondiagnostic initial ECGs
A 45-year-old man presents to the ED with 1 hour of chest pain, shortness of breath, and diaphoresis. 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
- antidromic SVT
- Aortic Dissection
- Approach to ECG
- Approach to ECG interpretation
- Appropriate Discordance
- April Fools
- Arrhythmogenic right ventricular cardiomyopathy
- Arrhythmogenic right ventricular dysplasia/cardiomyopathy
- Arrhythmogenic RV Dysplasia
- Artifact
- artifact vs. malignant arrhythmias
- artifact vs. torsades
- artifact vs. ventricular fibrillation
- Artifact vs. ventricular rhythm
- artifact vs. ventricular tachycardia
- Artificial Intelligence
- ARVC
- ARVD
- ASD
- Ashman
- Ashman phenomenon
- Aslanger
- 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 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
- Atrioventricular Reciprocating Tachycardia
- AV Block
- AV Block: Second-Degree
- AV Blocks
- AV Dissociation
- AV dissociation without complete heart block
- AVB
- AVB: 1st degree
- AVB: 2nd degree
- 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
- Brugada
- Brugada Pattern
- Brugada syndrome
- Buried P Waves
- CAD
- cannabis
- cannabis toxicity
- Cardiac arrest
- cardiac risk factors
- Cardiac tamponade
- cardiogenic shock
- Cardiovascular effects of marijuana
- Cardioversion
- CCB toxicity
- Cerebral T waves
- CHB
- Chemotherapy
- Chest Pain
- Classic STEMI Criteria
- clumped beats
- Clumped or Grouped Beats
- cocaine
- cocaine chest pain
- Cocaine toxicity
- 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
- 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
- dig effect
- 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
- ECG Competition 2023
- 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-Grade (Advanced AV Block)
- high-risk pulmonary embolism
- Himalayan T-waves
- history of ecg
- History of presenting illness
- HOCM
- Hypeacute T waves
- Hyperacute T-waves
- Hypercalcemia
- Hyperkalemia
- Hyperkalemia emergencies
- hyperkalemia mimics
- Hyperkalemic Periodic Paralysis
- Hypermagnesemia
- Hypertrophic Cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Hypocalcemia
- Hypokalemia
- hypokalemia emergencies
- 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 differential
- 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 regular tachycardia differential
- 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
- PJCs
- 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
- Pulse tapping artifact
- pulse-tapping
- 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
- Regularly Irregular Rhythm
- 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
- SHS
- 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
- Spiked Helmet sign
- spiked-helmet
- 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 differential diagnosis
- 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 differentials
- 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
- Understanding ECG Artifacts
- 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
- VT vs. SVT with Aberrancy
- w Voltage
- waveforms
- waves
- WCT
- Wellens
- Wellens waves
- Wellens’ syndrome
- Wide & Regular Tachydysrhythmia DDx
- 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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