STE in aVR
Results:
Several ECG cases from UMEM that highlight the importance of pattern recognition and a good history to differentiate between benign vs. life threatening ECG findings!
A 76-year-old woman is brought to the emergency department by EMS with for lightheadedness and syncope. The following ECG is obtained on arrival:
Differential Diagnoses: narrow complex irregular tachycardia, short QTc intervals, ST segment elevation in aVR, and so much more!
An 89-year-old woman is brought into the emergency department with generalized weakness and dizziness. She is noted to be bradycardic at triage. The following ECG is obtained with no prior…
STAT ECG Diagnoses: identification of acute coronary occlusion myocardial infarction in patients with bundle branch blocks
A 70-year-old woman is brought into the ED by EMS with shortness of breath, weakness, and hypotension. The following prehospital ECG is obtained:
5 more challenging EMS cases to help you test your emergency ECG interpretation skills
A 74-year-old man is brought into the ED by EMS with nausea, vomiting, and malaise. The following prehospital ECG was 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
- Anterior T wave inversions
- antidromic
- antidromic SVT
- Aortic Dissection
- Approach to ECG
- Approach to ECG interpretation
- Appropriate Discordance
- April Fools
- arrhythmogenic cardiomyopathy
- 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
- Attending Level Curriculum
- 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
- BBBs & Paced Rhythms vs. STEMI
- 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
- Bradycardia DDx
- BRASH syndrome
- Brugada
- Brugada Pattern
- Brugada syndrome
- Buried P Waves
- Buried T wave
- 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
- child
- child ecg
- 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
- DDx for TWIs in V1-V3
- de Winter
- de Winter T-wave
- de Winter T-waves
- defibrillation
- 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
- Early STEMI
- 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
- failure to capture
- failure to pace
- failure to sense
- Fascicular blocks
- fever
- Flattened T Waves
- Flutter Waves (F waves)
- Foundational Resident
- Fusion Beats
- GERD
- grouped beats
- Guidelines
- HCM
- 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 left ventricular voltages and 'dagger like' Q waves
- 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
- Hyperacute T-waves
- Hypercalcemia
- Hyperkalemia
- Hyperkalemia emergencies
- hyperkalemia mimics
- Hyperkalemia vs. STEMI
- Hyperkalemia vs. VT
- Hyperkalemic paralysis
- Hyperkalemic Periodic Paralysis
- Hyperkalemic Periodic Paralysis (“Impressive Syndrome”)
- Hypermagnesemia
- Hypertrophic
- Hypertrophic Cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Hypocalcemia
- Hypokalemia
- hypokalemia emergencies
- Hypokalemic paralysis
- hypokalemic periodic paralysis
- Hypomagnesemia
- hyponatremia
- Hypothermia
- Idioventricular rhythms
- Impressive syndrome
- in-training exam
- 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
- ITE prep
- ITE review
- 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 waves
- Juvenile T-wave pattern
- kid
- kid ecg
- kids
- 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)
- Left ventricular hypertrophy vs. STEMI
- 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
- New Q Waves
- New RBBB and LAFB
- 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
- Occlusion MI patterns
- OMI
- OMI pa
- 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
- P.E.
- PAC
- PAC’s
- Paced rhythms
- Pacemaker
- Pacemaker emergencies
- pacemaker malfunction
- 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 acs
- Pericarditis vs. STEMI
- Periodic paralysis
- Persistent juvenile T-wave pattern
- PFO
- PGY-2 (Intermediate) Resident Curriculum
- PGY-3 (Advanced) Resident Curriculum
- PGY1 Curriculum
- PJC
- PJCs
- PJTW
- plaque rupture
- plaque vulnerability
- Pokey T wave
- 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 OMI
- Posterior STEMI
- Posterior STEMI Criteria
- postural orthostatic tachycardia syndrome
- Potpourri
- POTS
- PR interval
- PR segment
- PR segments
- Pre-hospital ECG
- precordial lead misplacement
- precordial swirl
- 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
- RVH with strain
- 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
- South Africa sign
- South African
- South African Flag 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
- Student Level Curriculum
- Subtle ST elevation
- Subtle ST Segment Elevation (STE)
- Supraventricular tachycardia
- Supraventricular Tachycardia (SVT)
- Sustained VT
- SVT
- synchronization
- Syncop
- Syncope
- syncope ddx
- syncope differentials
- syncope emergencies
- Systematic approach to ECG
- T wave
- T wave inversion differential
- T Wave Inversion in V1-V3 DDx
- T wave inversions in V1-V3
- 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
- Terminal QRS Distortion (OMI Pattern)
- the basics
- The Curriculum
- Thrombolytics
- too many P waves
- Top 10 cases of the past 10 years
- 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
- Wolff-Parkinson White (WPW) Syndrome
- 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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