Basics & Fundamentals
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Ventricular Tachycardia (VT): Core Overview
Key Points: VT is a ventricular-origin rhythm: ≥3 consecutive ventricular beats, QRS >120 ms, rate usually 120–250 bpm. Types include monomorphic VT, polymorphic VT, torsades (PMVT with long QT), ventricular…
Prominent Upright T Wave in V1
Key Points: Normal T Wave in V1: The normal ECG typically shows a flat or inverted T wave in lead V1 in sinus rhythm. An upright T wave in V1 can…
Premature Atrial Complexes (PACs)
Key Points PACs are early atrial depolarizations from an ectopic focus that create a premature P wave with a different morphology and axis than the sinus P wave, usually followed…
Premature Junctional Complexes (PJCs)
Key Points PJCs are premature impulses from ectopic foci in or near the AV junction. ECG hallmark is a narrow premature beat with an absent or retrograde P wave. Retrograde…
Blocked Premature Atrial Complexes (PACs)
Key Points Definition: early ectopic atrial beats that do not conduct to the ventricles. You see a premature P wave with no following QRS and a pause that is usually…
J Wave: Basics
Key Points Definitions: The J point is the QRS–ST junction (a location). A J wave is an added deflection at or just after that point (notch or slur). Why it…
Premature Complexes (PACs, PJCs, & PVCs) Overview
Key Points: Premature complexes are early depolarizations arising from the atrium, AV junction, or ventricle which interrupt the expected sinus rhythm. Rapid classification by origin: look for a P wave…
Osborn (J) Wave: Basics
Key Points An Osborn wave is a notch or slur at the J point that becomes more prominent as core temperature falls. Most visible in inferolateral and precordial leads; can…
Premature Ventricular Complexes (PVCs)
Key Points PVCs are early ventricular depolarizations that produce a wide QRS with secondary ST-T changes and are usually followed by a full compensatory pause. No preceding P wave. A…
Spontaneous Coronary Artery Dissection (SCAD)
Key Points: Definition: SCAD is a spontaneous, nonatherosclerotic separation of the coronary arterial wall caused by intramural hematoma, with or without an intimal tear. Expansion within the vessel wall compresses…
ECG Lead Misplacement
Key Points: Lead misplacement is common and can mimic ischemia, MI, conduction blocks, and arrhythmias. Always verify placement when ECG and clinical picture do not match. V1 and V2 placed…
Proper ECG Electrode Placement
Key Points A diagnostic 12‑lead ECG is only as good as your electrode placement. Misplacement can mimic MI, BBB, or poor R‑wave progression and trigger unnecessary workups. A standard 12‑lead…
Cerebral T Waves
Key Points What it is: Dramatic ECG repolarization abnormality from acute brain injury. Classic pattern is deep, symmetric T-wave inversions with prolonged QTc, often most prominent in anterolateral leads. Why…
Accelerated Idioventricular Rhythm (AIVR)
Key Points: Definition: AIVR is a transient, usually benign ventricular rhythm often seen after reperfusion of an acute myocardial infarction (AMI), whether spontaneous or post-intervention (PCI or thrombolysis). Rate Differentiation:…
Atrioventricular Nodal Reentry Tachycardia (AVNRT)
Key Points: AVNRT is a paroxysmal, regular, usually narrow-complex SVT caused by a reentry circuit within or adjacent to the AV node. Dual-pathway physiology is typical. Bedside hallmark is a…
Atrioventricular Reciprocating Tachycardia (AVRT)
Key Points: AVNRT is a paroxysmal, regular, usually narrow-complex SVT caused by a reentry circuit within or adjacent to the AV node. Dual-pathway physiology is typical. Bedside hallmark is a…
Atrial Fibrillation with RVR
Key Points Most Common Sustained Arrhythmia: Atrial Fibrillation (AFib) is the most frequently encountered sustained arrhythmia in clinical practice, particularly among the elderly population. Misdiagnosis Risk: AFib is commonly misdiagnosed…
ECG Findings in Tension Pneumothorax
Key Points Tension pneumothorax is a clinical diagnosis—ECG changes are nonspecific but can provide supportive evidence in the right context. Electrical changes are primarily due to mechanical effects of air…
Acute Chest Pain: DDx
Key Points: In patients presenting with acute chest pain, identifying life-threatening conditions is essential. Use a systematic ECG approach alongside clinical context to evaluate for high-risk diagnoses that require immediate…
ECG Findings in Aortic Dissection
Key Points: Aortic dissection or aneurysm can produce ischemic‑appearing ECGs due to coronary malperfusion, most often right coronary involvement causing inferior changes. Pseudo‑infarction patterns, ST‑deviation, and conduction blocks can occur…
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