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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…
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…
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…
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…
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…
EMS ECGs in Acute Coronary Syndromes (ACS)
Key Points for EMS Providers: You are the first critical link in the chain of survival for ACS patients—your actions set the course for their care, directly impacting time to…
ECG Evidence of Reperfusion After Occlusion
Key Points Dynamic Nature: Coronary artery occlusions can spontaneously reperfuse or re-occlude, causing rapidly changing ECG patterns. Real-Time ECG Utility: Recognizing reperfusion ECG patterns allows early identification of successful artery…
Wolff-Parkinson White (WPW) Syndrome
Key Points Ventricular Pre-excitation: Occurs due to a congenital accessory pathway bypassing the AV node, leading to early ventricular activation. Commonly associated with Wolff-Parkinson-White (WPW) syndrome when symptomatic. WPW Complications:…
Atrial Fibrillation with WPW
Key Points WPW Syndrome: A condition characterized by ventricular pre-excitation due to a congenital accessory pathway, often associated with symptomatic arrhythmias. ECG Recognition: The WPW pattern is best identified when…
Subtle ST Segment Elevation (OMI Pattern)
Key Points ACS Dynamics: Occluded arteries in ACS can spontaneously reperfuse and reocclude, making ECG findings variable. Limitations of Computer Interpretation: Subtle STE is often missed by computerized ECG interpretation;…
de Winter T Waves (OMI Pattern)
Key Points STEMI Equivalent: The de Winter ECG pattern is an uncommon STEMI equivalent indicative of an unstable proximal occlusion of the LAD (left anterior descending coronary artery). This pattern…
South African Flag Sign (OMI Pattern)
Key Points Pattern Recognition: The South African Flag Sign is characterized by: ST-segment elevation (STE) in leads I, aVL, and V2. ST-segment depression in lead III. Subtle but visually distinctive…
New RBBB and LAFB in ACS (OMI Pattern)
Key Points Pattern Recognition: New-onset Right Bundle Branch Block (RBBB) and Left Anterior Fascicular Block (LAFB) occurring together is a high-risk ECG finding. Often associated with proximal Left Anterior Descending…
Acute Pericarditis vs. STEMI
Key Points Acute Pericarditis: A challenging diagnosis with symptoms and ECG findings that may mimic STEMI. STEMI: A more life-threatening and time-sensitive condition. Differentiation from pericarditis is crucial to avoid…
Bidirectional Ventricular Tachycardia
Key Points Definition: Bidirectional Ventricular Tachycardia (VT) is a rare and unique form of VT characterized by QRS complexes that alternate in axis and morphology from beat to beat. This…
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…
Hypokalemic Periodic Paralysis
Key Points Definition: A rare ion channelopathy that causes sudden, reversible episodes of symmetric flaccid paralysis triggered by low serum potassium. It may be inherited or secondary to thyrotoxicosis or…
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…
Metabolic Emergencies
Key Points A Simple Yet Powerful Tool: With just a piece of paper and some ink, the ECG can unveil life-threatening metabolic emergencies, giving you the power to detect critical…
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