Latest
Post-Arrest STEMI: Cath Lab or Caution?
A 72-year-old man is brought to the ED after witnessed cardiac arrest. Bystander CPR was started quickly, EMS found a nonshockable rhythm, epinephrine was given, and ROSC was achieved. Forty…
A Post-Arrest ECG With a Dangerous New Bundle Branch Block
A 72-year-old man is brought to the ED after a witnessed out-of-hospital cardiac arrest. Bystander CPR is started quickly, EMS finds a non-shockable rhythm, and ROSC is achieved after one…
The Cath Lab Was Activated, But Something Didn’t Fit
A 70-year-old woman with CHF, COPD, intermittent atrial fibrillation, chronic pain medication use, and recent poor intake develops sudden dyspnea at rest and is found somnolent and bradycardic in the…
UMEM Cases, Part 4: When the Computer Misses the Rhythm and Flutter Fakes a STEMI
A 44-year-old man with severe cardiomyopathy, an LVAD, chronic amiodarone therapy, and an AICD presents with palpitations. His ECG shows a regular wide-complex tachycardia, but the rate is only 135….
UMEM Cases, Part 3: When the Diagnosis Seems Clear and When It Is Not
A 71-year-old man presents with shortness of breath, and his ECG is initially read as a junctional rhythm. On later review, it is even mistaken for atrial fibrillation. But the…
UMEM Cases, Part 2: When the ECG Conceals and When It Reveals
An 81-year-old woman presents with lightheadedness and marked bradycardia. Her ECG shows more P waves than QRS complexes, but the mechanism is not immediately clear. The key question is whether…
UMEM Cases, Part 1: When the ECG Lies and When It Evolves
A 72-year-old man presents with chest pain and shortness of breath. His ECG shows sinus rhythm with LVH, mild inferior ST elevation, and lateral ST-T abnormalities that some interpret as…
Subtle ST Abnormalities and a Difficult Cath Lab Decision
A 60-year-old man presents with chest pain that seems a little better after belching, but his clinician is not reassured. The initial ED ECG shows subtle ST-segment abnormalities, the computer…
Three ECG Traps You Cannot Afford to Miss
A 60-year-old woman presents with palpitations and an irregular wide-complex tachycardia. The computer calls atrial fibrillation with a left bundle branch block, but a subtle clue in the precordial leads…
The Syncope ECG With Too Much P
A 68-year-old man has syncope, then has a second syncopal episode while lying still on a stretcher during evaluation at an outpatient clinic. He is sent emergently to the ED….
Preexcitation Pitfalls (Part 4): Potpourri Cases & Final Teaching Points
A 49-year-old man arrives with palpitations and chest discomfort. The monitor shows an irregular, wide-complex tachycardia with varying morphology and rates nearing 250 to 300 bpm. The team debates polymorphic…
Preexcitation Pitfalls (Part 3): Wide, Irregular, Fast…Avoid AV Nodal Blockers
A 53-year-old man presents with palpitations and lightheadedness. The following ECG is obtained on arrival and appears very rapid and irregular with changing QRS morphologies. He starts showing signs of…
Preexcitation Pitfalls (Part 2): Wide, Regular, Fast…Treat It Like VT
A young man with recurrent palpitations presents to the emergency department hemodynamically stable during an episode. The arrival ECG shows a wide complex, regular tachycardia and the computer interpretation calls…
Preexcitation Pitfalls (Part 1): The “Inferior STEMI” That Isn’t
A critically ill 38-year-old man presents hypotensive, pale, and diaphoretic with abdominal pain and rectal bleeding. Upright chest X-ray shows free air under the diaphragm, and the patient is headed…
Baltimore City EMS ECGs: Pitfalls and Mimics (Part 2)
A 54-year-old man presents to the emergency department by EMS with acute shortness of breath. A prehospital ECG triggers a STEMI alert based on the computer interpretation. The tracing shows…
Baltimore City EMS ECGs: Pitfalls and Mimics (Part 1)
A 68-year-old man is brought to the emergency department by EMS with acute chest discomfort. The following prehospital ECG was obtained and shows concave ST elevation across multiple leads. The…
Three More ECG Pitfalls That Punish Anchoring Bias
A 51-year-old man with lung cancer presents with shortness of breath and tachycardia. The arrival ECG shows an S1Q3 pattern and seems to support a familiar diagnosis that would normally…
Four ECG Pitfalls That Punish Anchoring Bias
A 43-year-old woman with sharp left-sided chest pain and minimal cardiac risk factors has an initial ECG that is not diagnostic for STEMI. She looks stable, but one feature on…
Dr. Mattu’s 5 Favorite ECG Cases of 2025
A 68-year-old man presents after syncope with profound bradycardia. The ECG shows a very slow ventricular rate with high-grade AV block. The reflex move is to focus only on pacing,…
Reciprocal Depression in aVL: The Case for Serial ECGs
A 62-year-old man presents to the emergency department with acute chest pain associated with diaphoresis. He has cardiac risk factors including tobacco use. An initial 12-lead ECG is obtained on…
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
© 2026 ECG Weekly. All rights reserved. | Terms of Use | Privacy Policy
Powered by the member(dev) platform
Loading...