Basics & Fundamentals
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Ectopic Atrial Rhythm
Key Points Definition: Ectopic atrial rhythms occur when atrial depolarization originates from a site other than the sinoatrial (SA) node, producing P waves with abnormal morphology and axis on ECG….
Brugada Syndrome (BrS)
Key Points Life-Threatening Sodium Channelopathy: Predisposes to ventricular arrhythmias (VF/VT) and sudden cardiac death (SCD), often in otherwise “healthy” hearts. When to Suspect BrS: Patients with syncope, unexplained “seizures,” ventricular…
Sinoatrial Nodal Reentry Tachycardia (SANRT)
Key Points Definition: Sinoatrial Nodal Reentrant Tachycardia (SANRT) is a rare type of paroxysmal supraventricular tachycardia (SVT) characterized by a reentry circuit within the sinoatrial (SA) node, similar in mechanism…
Left Bundle Branch Block
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…
T Wave Alternans
Key Points Definition: T wave alternans (TWA) is a phenomenon where there is a beat-to-beat variation in the amplitude or morphology of the T wave on the ECG, without affecting…
Hypomagnesemia
Key Points Prolonged QT & PR Intervals significantly increase the risk of torsades de pointes and other arrhythmias. Atrial & Ventricular Ectopy is common; can progress to life-threatening ventricular tachycardia….
WPW Syndrome and Pseudo-MI patterns
Key Points WPW Pattern Mimics: Wolff-Parkinson-White (WPW) syndrome can produce an ECG pattern that mimics conditions such as myocardial infarction, ventricular bigeminy, accelerated idioventricular rhythm, and electrical alternans. ST Segment…
Hyperkalemia Emergencies
Key Points Severe Hyperkalemia Mimics Several Life-Threatening Conditions: Hyperkalemia can produce a wide range of ECG abnormalities that resemble unstable brady and tachy arrhythmias, STEMI, and can also cause pacemaker…
Pulse-Tapping Artifact
Key Points Pulse tapping artifact is caused by arterial pulsations mechanically influencing an ECG electrode, often leading to ST-segment changes and bizarre T waves. It mimics critical conditions like myocardial…
Pediatric ECG Essentials
Key Points Rightward Axis in Kids: Early in life, the right ventricle is dominant, producing a large R wave in V1–V2 and minimal S waves in V5–V6. Significance: Recognize this…
Arrhythmogenic Cardiomyopathy (ACM)
Key Points Definition & Terminology: Arrhythmogenic Cardiomyopathy (ACM), previously known as Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D), is an inherited disorder characterized by progressive fibrofatty replacement of the ventricular myocardium, predominantly…
Spiked Helmet Sign (SHS)
Key Points The Spiked Helmet Sign (SHS) is a rare but important ECG pattern characterized by pseudo ST-segment elevation that starts before the onset of the QRS complex. SHS is…
Atrial Parasystole
Key Points Definition: A rare arrhythmia in which a secondary atrial focus fires at its own inherent rate, largely “shielded” from sinus node impulses. Characteristic ECG Finding: Two distinct P-wave…
Early Repolarization vs. STEMI
Key Points Differentiation Challenge: Early repolarization (ER) is a benign ECG pattern often seen in healthy young individuals, characterized by ST segment elevation that can mimic STEMI and acute pericarditis….
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…
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…
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…
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