STEMI

Weekly Workout January 20, 2020

Literature Review: modified Sgarbossa criteria in the diagnosis of acute coronary occlusion MI in paced rhythms

A 81-year-old male with PMHx of HTN and CAD s/p pacemaker insertion, presents to the ED complaining of chest pain radiating down both arms x 1 hour. He reports improvement…

Weekly Workout January 5, 2020

ECG Basics & Fundamentals: normal and expected findings in right bundle branch block (RBBB) vs patients with occlusion MI

A 61-year-old male with PMHx of atrial fibrillation on anticoagulation presents to the ED with chest pain for 1 day after eating beef stew. He is concerned about having bad…

Weekly Workout November 18, 2019

Differential Diagnoses: factors that rule in STEMI in the evaluation of diffuse ST segment elevation

A 60-year-old male presents to the ED with chest pain and mild dyspnea. The following ECG is obtained:

Weekly Workout November 11, 2019

Rhythm Interpretation: distracted by ectopy!

HPI: A 51-year-old male presents to the ED with dyspnea, nausea, and palpitations. The following ECG is obtained: Case ECG Before watching this week’s video, ask yourself these questions:…

Weekly Workout November 3, 2019

ECG Basics and Fundamentals: expected ECG findings in right ventricular (RV) paced rhythms

A 71-year-old male with PMHx of hypertension and pacemaker placement presents to the ED with chest pain, nausea, diaphoresis, and shortness of breath. The following ECG is obtained:

Weekly Workout October 28, 2019

Differential Diagnoses: new right axis deviation and ST segment elevation

A 27-year-old male with no PMHx is brought in by ambulance for right shoulder pain, nausea, and generalized weakness. He is confused with a blood pressure of 60/40. The following…

Weekly Workout October 20, 2019

Post-cardiac arrest ECGs: can you guess the cause of arrest based off this ECG?

A 56-year-old man is brought in by ambulance after witnessed cardiac arrest. He reportedly had shortness of breath and malaise prior to collapse. The following post ROSC ECG is obtained:

Weekly Workout September 30, 2019

Differential Diagnoses: poor R wave progression and attention to T wave abnormalities

A 55-year-old woman presents with substernal chest pressure radiating to the left upper extremity, dyspnea, and nausea. She has a past medical history of HTN, DM, HLD, and is a…

Weekly Workout September 23, 2019

STAT ECG Diagnoses: does the presence of a LBBB obviate the ability to diagnose occlusion MI?

A 48-year-old man presents with 90 minutes of chest pain. He is hemodynamically stable and has a normal first troponin. The following ECG is obtained:

Weekly Workout August 12, 2019

Differential Diagnoses: terminal QRS distortion in the differentiation of STEMI from early repolarization

A 43-year-old male presents to the emergency department with chest pain. The following ECG is obtained:

Weekly Workout July 8, 2019

2019 ECG Competition Answers (Part 3/3)

This week we review the answer to question 12 from the 7th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red box to…

Weekly Workout July 1, 2019

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…

Weekly Workout June 24, 2019

2019 ECG Competition Answers (Part 1/3)

This week we review the answers to the first 6 questions from the 7th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…

Weekly Workout June 17, 2019

Acute chest pain in a patient with a known right bundle branch block (RBBB)

A 63-year-old male with multiple cardiac risk factors presents to a busy ED with chest pain. He has normal vital signs and a known right bundle branch block. The following…

Weekly Workout May 20, 2019

Literature Review: safety of computer interpretation of normal triage electrocardiograms

A 64-year-old male with PMHx of hypertension and hyperlipidemia presents to the ED with chest pain associated with vomiting and shortness of breath. The patient looks sick. The following ECG is…

Weekly Workout March 25, 2019

STAT ECG Diagnoses: criteria for right ventricular myocardial infarction (RVMI)

A 52-year-old male presents to the emergency department with 1 hour of right sided chest pain that woke him up in the middle of the night. Chest pain is associated…

Weekly Workout February 4, 2019

Literature Review: occlusion MI in paced rhythms

HPI: An 84-year-old male presents to the emergency department with 4 hours of chest pain. He has a history of coronary artery disease and has a pacemaker. The following ECG…

Weekly Workout January 7, 2019

ECG Basics & Fundamentals: respect the T waves!

A 29-year-old male presents to the emergency department with a mild headache and dyspnea. He is an avid cyclist who biked 40 miles the day before. His exam is normal….

Weekly Workout November 26, 2018

Literature Review: severe hyperkalemia, ST segment elevation in aVR, and many more interesting topics

A 60-year-old woman with PMHx of HTN is brought in by EMS with chest pain and diaphoresis. The following prehospital ECG was obtained:

Weekly Workout November 19, 2018

Literature Review: 2018 STEMI & STEMI equivalent guideline updates (Part 3/3)

A 80-year-old man presents to the ED with midsternal chest pain concerning for an acute coronary syndrome. The following ECG is obtained:

Results: