HPI
This week we review the answers to the first 6 questions from the 9th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video or clicking the answer boxes in the summary section to reveal the answers and take home points!
Kudos: Thanks to Ahmed Abbas & Javier Chavarría for sharing their cases!
Question #1. A 50-year-old man presents with chest pain and has STE in both limb leads and precordial leads.
1a. What is the diagnosis? (1 pt)
1b. What is the basis for your answer in 1a (versus other potential causes of diffuse STE). (2 pts)
Case # 1 Answer
1a. STEMI (LAD) (1 point)
1b. Hyperacute T waves, terminal QRS distortion in V3 (2 points)
Question #2. A 79-year-old man presents after a syncopal episode with this ECG. What is the rhythm diagnosis? (2 pts)
Case # 2 Answer
2. Sinus rhythm, complete heart block, junctional escape rhythm (2 points)
Question #3: A 74-year-old woman reports intermittent SOB and nausea all day. This is her ECG.
Vitals: afeb, HR 115, BP 125/65, RR 21, SpO2 96%, FS 100. Looks ok, lungs clear.
3a. What is the ECG diagnosis? (1 pt)
3b. What is your management for this rhythm? (2 pts)
Case # 3 Answer
3a. Accelerated idioventricular rhythm (AIVR) (1 point)
3b. No medications for the rhythm, call cardiology for cath (2 points)
Question #4: A 35-year-old man presents with agitation and delirium. After giving some benzodiazepines for sedation, you get this ECG.
4a. What is the drug of choice to treat this condition? (1 pt)
4b. What are 4 ECG findings that will improve with treatment? (2 pts)
Case # 4 Answer
4a. Sodium bicarbonate (1 point)
4b. Sinus tachycardia, right axis deviation, tall R wave in aVR, tall R wave in V1, wide QRS (2 points)
Question #5: A 60-year-old woman presents with CP and this ECG. Please provide a FULL ECG interpretation (3 pts).
Case # 5 Answer
5. Sinus tachycardia, right bundle branch block, left posterior fascicular block, anterior STEMI (3 points)
Question #6: A 77-year-old woman presents after a syncopal episode and has this ECG.
6a. What was the probable cardiac rhythm that caused the syncope? (1 pt)
6b. What is the treatment for this patient? (1 pt)
Case # 6 Answer
6a. Torsades due to hypocalcemia (1 point)
6b. IV Calcium (1 point)