Key Points STEMI Equivalent: The de Winter ECG pattern is an uncommon STEMI equivalent indicative of an unstable proximal occlusion of the LAD (left anterior descending coronary artery). Treat the…
Key Points What it is: In V2 or V3, there is no S wave (the R does not descend below the PQ baseline) and no J wave (no notch/slur at…
Key Points ACS Dynamics: ACS is complex and dynamic, with occluded arteries potentially reperfusing and reoccluding at any time. ECG Pattern Recognition: Mastering ECG pattern recognition in ACS is crucial…
Key Points LBBB Does Not Exclude Acute Coronary Occlusion: LBBB alters ventricular activation, leading to expected secondary ST/T abnormalities. However, acute occlusion myocardial infarction (OMI) can and must still be…
Key Points STEMI Diagnosis and Contiguous Leads: While current guidelines typically require ST elevation (STE) in at least two contiguous leads for the diagnosis of STEMI, this practice is not…
Key Points ACS Dynamics: Occluded arteries in ACS can spontaneously reperfuse and reocclude, making ECG findings variable. Limitations of Computer Interpretation: Subtle STE is often missed by computerized ECG interpretation;…
Key Points Pattern Recognition: The South African Flag Sign is characterized by: ST-segment elevation (STE) in leads I, aVL, and V2. ST-segment depression in lead III. Subtle but visually distinctive…
Key Points Pattern Recognition: New-onset Right Bundle Branch Block (RBBB) and Left Anterior Fascicular Block (LAFB) occurring together is a high-risk ECG finding. Often associated with proximal Left Anterior Descending…
A 51-year-old man presents to the emergency department with acute chest pain that has progressively worsened over the past 3 hours. Pain radiates to the jaw and is associated with…
A 50-year-old woman presents to the emergency department with acute chest pain. The following ECG is obtained on arrival:
A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain. Pain is…
A 58-year-old woman is brought into the emergency department by paramedics with chest pain and diaphoresis. The following EMS ECG was obtained:
A 70-year-old man presents to the ED with ischemic chest pain. The following ECG is obtained:
A 70-year-old man presents to the ED with radiating chest tightness, nausea, and diaphoresis. The following ECG is obtained:
A 52-year-old man with history of hyperlipidemia and smoking presents to the ED with 2 hours of radiating chest pressure associated with diaphoresis and dyspnea. The following ECG is obtained: