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Key Points

  • Definition: A differential diagnosis is the structured process of considering multiple possible conditions that could explain a patient’s symptoms and ECG findings.
  • Purpose: The goal is to narrow down possibilities to reach the most accurate and timely diagnosis, guiding effective management.
  • Clinical Significance: Thorough differentials prevent misdiagnosis, improve safety, and optimize outcomes. In acute care, where history and exam may be limited, ECG-based DDx lists help identify critical conditions early.
  • Practical Use: When you identify an ECG abnormality, anchor your thinking with a focused list of the most important and life-threatening differentials before moving to less urgent possibilities.

KEY CLINICAL PEARLS:

  • Always Consider the Worst Case: Prioritize life-threatening diagnoses (e.g., OMI, PE, hyperkalemia, VT) to ensure they are ruled out early.
  • Use a Structured Approach: Apply a systematic, stepwise method to avoid overlooking critical diagnoses.
  • Reassess Frequently: Update your differential as new clinical data, labs, or imaging become available. The differential should evolve with the patient’s course.