Wide QRS
Results:
Left Bundle Branch Block (LBBB)
Key Points: Definition: LBBB occurs when electrical conduction through the left bundle branch is delayed or blocked, resulting in asynchronous and delayed activation of the left ventricle (LV) and a…
Ventricular Escape Rhythms
Key Points Wide QRS Complex Rhythm: Ventricular escape rhythms (aka idioventricular rhythms) are characterized by a wide QRS duration (>120 ms), absent or dissociated P-waves, and a regular, slow ventricular…
Left Bundle Branch Block (LBBB): DDx
Key Point Overview: Left bundle branch block (LBBB) is an intraventricular conduction delay that results from a block in the left bundle branch of the heart’s electrical conduction system. It…
Wide QRS Bradyarrhythmia: DDx
Key Point Wide QRS bradycardias usually reflect infranodal conduction disease (His–Purkinje or below), making them much more dangerous than narrow QRS bradycardias. These rhythms often lead to hemodynamic instability and…
Polymorphic Ventricular Tachycardia (PMVT)
Key Points Definition: PMVT is a ventricular tachycardia characterized by beat-to-beat variations in QRS morphology, axis, and duration, reflecting multiple ventricular foci or reentrant circuits. Clinical Importance: PMVT is often…
Sodium Channel Blocker Toxicity
Key Points Recognizing the Danger: Sodium channel blocker toxicity can present with a variety of ECG changes that are critical to recognize, especially in patients with altered mental status or…
Nonsustained Ventricular Tachycardia
Key Points Definition: NSVT is defined as ≥3 consecutive ventricular beats, QRS duration >120 ms, rate typically 100-250 bpm (usually > 120 bpm), lasting less than 30 seconds without causing…
Wide Complex Tachycardias: does response to Valsalva maneuvers or adenosine rule out ventricular tachycardia?
A 54-year-old man with no significant PMHx presents to the ED with palpitations. He is hemodynamically stable with a normal blood pressure. The following ECG is obtained prior to the…
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…
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…
Differential Diagnoses: wide QRS, right axis deviation, tall R wave in V1
A 76-year-old woman presents to the ED with dyspnea and a syncopal episode. History is limited because the patient is listless and confused. The following ECG was obtained:
Literature Review: Wolff-Parkinson-White syndrome with atrial fibrillation
A 50-year-old man is referred from clinic to the ED for chest tightness for the past 3 hours and a presumed new left bundle branch block. He is found to…
STAT ECG Diagnoses: must know ECG differentials in the evaluation of patients with altered mental status
A young woman presents to the ED unconscious with a GCS of 4. The following ECG was obtained during the initial evaluation:
ECG Basics & Fundamentals: a 5 step approach to ECG interpretation and how to think of differential diagnoses
HPI: A 70-year-old man presents with generalized malaise. He has a history of ESRD and has missed dialysis this week. The following ECG is obtained: Case ECG Before watching…
ECG Basics & Fundamentals: a systemactic approach to ECG interpretation
HPI: A 78-year-old male presents to the ED complaining of generalized weakness. Case ECG
Differential Diagnoses: the biggest reason we miss a diagnosis is that we make a diagnosis, and then stop looking
HPI: An unresponsive 45-year-old male is brought in to your ED by ambulance. His wife found him unconscious at home and called 911. History is otherwise limited. Case ECG
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