Life Savers
Latest
Sinus Node Dysfunction (Sick Sinus / Brady–Tachy Syndrome)
Key Points Spectrum, not one rhythm: Look for sinus brady, pauses, arrest, alternating atrial tachyarrhythmias (AF, flutter, ATach). Symptoms matter: Syncope, presyncope, fatigue usually come from cerebral/systemic hypoperfusion, especially after…
Slow Atrial Fibrillation
Key Points Definition: Atrial fibrillation with a slow ventricular response, usually < 60 bpm. ECG: Irregularly irregular rhythm, no discrete P waves, slow R-R intervals. Common causes: AV-nodal blockers (digoxin,…
Aslanger Pattern (OMI Pattern)
Key Points STEMI Diagnosis and Contiguous Leads: While current guidelines typically require ST elevation (STE) in at least two contiguous leads for the diagnosis of STEMI, this practice is not…
Precordial Swirl (OMI Pattern)
Key Points Definition: The precordial swirl sign refers to a rotational pattern of ST-segment abnormalities across the precordial leads, suggesting a dynamic and evolving occlusion myocardial infarction (OMI). It is…
ST Elevation in aVR with Diffuse ST Segment Depression
Key Points Pattern: ST elevation in aVR (≥1 mm), often with ST elevation in V1 and widespread ST depression (≥1 mm in ≥6 leads). Mechanism: Reflects global subendocardial ischemia, often…
Pericardial Tamponade
Key Points Beyond Electrical Alternans: Although classically linked to tamponade, electrical alternans is present in fewer than 30% of confirmed cases. It’s abscence should never rule out tamponade. Low Voltage…
Electrical Alternans
Key Points Classically associated with pericardial tamponade but seen in fewer than 30% of confirmed cases. Combination of low-voltage QRS + sinus tachycardia strongly suggests pericardial effusion/tamponade. Always perform rapid…
Polymorphic Ventricular Tachycardia (PMVT)
Key Points Definition: PMVT is a ventricular tachycardia characterized by beat-to-beat variations in QRS morphology, axis, and duration, reflecting multiple ventricular foci or reentrant circuits. Clinical Importance: PMVT is often…
Posterior STEMI Criteria
Key Points High Risk of Missed Diagnosis: Isolated posterior occlusion MI is frequently missed due to the absence of ST elevation on standard 12-lead ECG. Instead, ST depression in V1–V3…
ST Depression V1-V4 (Posterior OMI Pattern)
Key Points Most Missed STEMI: Isolated posterior MI is the most commonly missed occlusion MI due to the absence of ST elevation on standard 12-lead ECG. ECG Pattern of Posterior…
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…
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…
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…
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;…
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…
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…
Free Content
Jump on our email list for free tips and insights delivered to your inbox monthly. No spam - just quick pearls and ECG education.
Categories
- No categories
© 2025 ECG Weekly. All rights reserved. | Terms of Use | Privacy Policy
Powered by the member(dev) platform
Loading...