Basics & Fundamentals
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LV Aneurysm vs. STEMI
Key Points Left Ventricular Aneurysm (LVA): Causes persistent ST elevation lasting more than 2 weeks post-MI, typically seen in the anterior leads but can also affect the inferior leads. Occurs…
Upright T waves in V1
Key Point Normal T Wave in V1: The normal ECG typically shows a flat or inverted T-wave in lead V1. Upright T-Wave Abnormality: An upright T-wave in V1 (TV1) should…
Understanding ECG Artifacts
Key Points ECG artifacts are distortions in the ECG signal that mimic or obscure true cardiac activity. Artifacts can arise from patient-related factors, technical issues, or environmental interference. Common types…
Q Wave Basics
Key Points Definition: Q waves are the first negative deflection of the QRS complex, representing early ventricular depolarization. They are measured in duration (ms) from the begining to the end…
WPW with Antidromic SVT
Key Points WPW Syndrome: Wolff-Parkinson-White (WPW) syndrome is a condition characterized by ventricular pre-excitation due to a congenital accessory pathway in patients with symptomatic arrhythmias. ECG Recognition: The classic WPW…
WPW with Orthodromic SVT
Key Points WPW Syndrome: Wolff-Parkinson-White (WPW) syndrome is a condition where ventricular pre-excitation occurs due to a congenital accessory pathway in patients with symptomatic arrhythmias. ECG Recognition: The WPW ECG…
Premature Junctional Complexes (PJCs)
Key Points Origin: PJCs originate from ectopic foci near the AV junction, leading to premature impulses. ECG Characteristics: P Waves: May be absent or retrograde (inverted), appearing before, during, or…
Premature Ventricular Complexes (PVCs)
Key Points Origin and Characteristics: PVCs originate from ectopic ventricular foci, resulting in wide QRS complexes (>120 ms) with abnormal morphology, including discordant ST segments and T wave abnormalities. Types…
Premature Atrial Complexes (PACs)
Key Points Origin and Characteristics: PACs originate from ectopic atrial foci, resulting in abnormal P waves with different morphology and axis compared to sinus P waves. Hidden P Waves: Ectopic…
Premature Complexes (PACs, PJCs, & PVCs)
Key Points Spontaneous Depolarization: Different pacemaker cells in the heart can spontaneously depolarize at varying rates; the SA node is usually the fastest. Ectopic Impulses: Early depolarizations from ectopic foci…
Attending Level ECG Curriculum
Competencies: At the attending level, expert emergency and acute care physicians should proficiently interpret STAT ECGs to diagnose a wide range of emergent conditions—particularly those that are rapidly fatal. Mastery…
PGY-3 (Advanced) Resident ECG Curriculum
The Goals: Master rare and complex ECG findings and correlate them with clinical urgency. Integrate ECG data into immediate treatment decisions (e.g., combining with POCUS, vital signs, and physical exam)….
PGY-2 (Intermediate) Resident Curriculum
The Goals: Enhance speed and accuracy in ECG interpretation through repetition and practice. Recognize subtler findings and expand your differential diagnoses. Integrate nuanced ECG changes into clinical decision-making. Mentor junior…
PGY-1 (Foundational Resident) Curriculum
The Goals: Establish a systematic approach, identify common arrhythmias, distinguish normal variants from dangerous abnormalities, and maintain a strong emphasis on clinical correlation. Core Topics Systematic Interpretation Step-by-Step Method: Rate…
Student Level ECG Curriculum
Pre-Licensure / Pre-Residency Designed for Medical Students, Paramedics, Nursing Students, ED Technicians, or anyone else who wants to start learning more about how to use ECGs effectively in clinical settings….
The ECG STAT Curriculum
Why ECG Interpretation Matters Electrocardiograms (ECGs) are a cornerstone of patient evaluation and management in acute care. Rapid, accurate interpretation can mean the difference between timely intervention and missed critical…
R Wave Basics
Key Points Definition: The R wave is the first positive deflection seen on the ECG during the QRS complex, representing early ventricular depolarization. R Wave Transition Zone: Normally, the R…
Acquired Long QT Syndrome
Key Points Acquired Long QT Syndrome (LQTS) is the most common form of LQTS, resulting from medications, electrolyte disturbances, or underlying medical conditions. High-risk factors include the use of multiple…
Himalayan T Waves
Key Points Himalayan T waves are a peculiar T wave abnormality characterized by T wave/U wave fusion, resulting in a mountain peak-like appearance on the ECG. This pattern is strongly…
Normal QRS Axis
Key Points Normal Axis Range: –30° to +90° Lead I: QRS complex is positive Lead aVF: QRS complex is positive → This combination confirms a normal QRS axis Frontal plane…
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