Basics & Fundamentals
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Abnormal STAT ECG
Key Points Clinical Context: Abnormal ECG findings in emergent settings must always be interpreted within the clinical context. Not all abnormalities represent life-threatening conditions, while severe conditions may present subtly…
Ventricular Fibrillation (VF)
Key Points Rapidly Fatal Rhythm: VF is the most critical shockable cardiac arrest rhythm, requiring immediate defibrillation and high-quality CPR to prevent sudden cardiac death within minutes. Chaotic Electrical Activity:…
Third-Degree AV Block
(Complete Heart Block)
Key Points Definition: Third-degree AV block is complete failure of conduction from atria to ventricles, resulting in independent atrial and ventricular activity—known as AV dissociation. Hallmark Feature: No P waves…
Acute Coronary Syndromes (ACS)
Key Points ECG First: The ECG is the most important initial test for suspected ACS. STAT ECGs help identify acute coronary occlusion MI (OMI) that require emergent reperfusion. Time-Sensitive Dx:…
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…
The Lewis Lead (Unmasking Atrial Activity)
Key Points Purpose: The Lewis Lead (modified S5 lead) is a bedside ECG modification designed to enhance visualization of atrial activity, particularly valuable in differentiating challenging arrhythmias such as VT…
Monomorphic Ventricular Tachycardia
Key Points Most Common Form: Monomorphic VT is the most frequent type of sustained ventricular tachycardia. Rate: Typically regular, rapid heart rate (>120-130 bpm). Be cautious of mimics when rate…
Ventricular Tachycardia (VT)
Key Points Definition: VT is a wide complex tachycardia arising from the ventricles, defined as ≥3 consecutive ventricular beats, QRS duration >120 ms, with rapid heart rate typically 120-250 bpm….
Supraventricular Tachycardia (SVT)
Key Points Definition: SVT refers to any tachyarrhythmia that originates above the ventricles (atria, AV node, or bundle of His). Most present as regular narrow-complex tachycardias, although aberrant conduction can…
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…
Atrial Tachycardia
Key Points: Definition: Atrial tachycardia is a supraventricular arrhythmia characterized by rapid atrial depolarizations from one or more ectopic foci outside the SA node. Atrial Rate: > 100 bpm, typically…
Atrial Flutter 2:1 Conduction
Key Points Mechanism: Atrial flutter results from a macro re-entry circuit typically located within the right atrium, causing rapid and regular atrial activation (~300 bpm commonly). ECG Appearance: Classic “saw-tooth”…
Atrial Fibrillation (AFib)
Key Points Prevalence: The most common sustained cardiac arrhythmia, particularly prevalent among elderly individuals, associated with increased stroke, heart failure, and mortality risks. Mechanism: Caused by chaotic, multiple reentry circuits…
Accelerated Idioventricular Rhythm (AIVR)
Key Points Definition: AIVR is a benign, self-limited ventricular rhythm frequently observed following reperfusion in acute myocardial infarction (AMI). Rate Differentiation: Characterized by a regular wide-complex rhythm with a ventricular…
Hypocalcemia
Key Points Prolonged QTc as the Hallmark ECG Change: Hypocalcemia primarily lengthens the ST segment, leading to a prolonged QTc interval, increasing the risk of arrhythmias like Torsades de Pointes…
Ischemia & Infarction
Key Points Purpose of ECG in ACS: One of the primary uses of an ECG is to detect signs of cardiac ischemia and infarction. Understanding the pathophysiology of Acute Coronary…
Acute Pericarditis
Key Points Diagnostic Challenge: Acute pericarditis symptoms and ECG findings can closely resemble STEMI/ACS, leading to frequent diagnostic uncertainty in acute care. Critical Importance: Rapid and accurate differentiation from STEMI…
P Wave Basics
Key Points Definition: The P wave represents atrial depolarization (the electrical activation of the atria immediately preceding atrial contraction). It is the first deflection or waveform in the ECG cardiac…
ECG 101: The Basics
Key Points: ECGs in Acute Care Medicine Rapid, Non-Invasive Screening Tool: ECGs provide quick, cost-effective assessment of cardiac function and rhythm. When interpreted accurately, they can significantly alter patient management…
Spontaneous Coronary Artery Dissection (SCAD)
Key Points SCAD Definition: A spontaneous, non-atherosclerotic tear in the coronary artery wall, often affecting young, otherwise low-risk women (including peripartum patients). SCAD presents similarly to ACS and is an…
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