Quiz: 2026 ECG Competition Answers (Part 2)

1. A 33-year-old woman with reproducible chest wall pain and low clinical concern for ACS has shallow, asymmetric T-wave inversions limited to V1–V3. What is the most likely diagnosis?

Wellens syndromePersistent juvenile T-wave patternPulmonary embolismBrugada syndrome

2. Which of the following is not a typical cause of T-wave inversions in V1–V3?

RBBBPulmonary embolismArrhythmogenic right ventricular cardiomyopathySevere hypercalcemia

3. A hypotensive patient’s ECG appears to show a wide-complex rhythm in the precordial leads, but lead aVL reveals that the QRS is not truly wide and that massive ST elevation is merging with the QRS complex. What is the most likely diagnosis?

HyperkalemiaSodium channel blocker toxicityMassive STEMIVentricular tachycardia

4. A patient with a clear STEMI arrests in a hospital without immediate cath lab availability. According to the teaching point from this episode, what medication should be called for?

AmiodaroneProcainamideEmpiric thrombolyticsCalcium gluconate

5. Which T-wave inversion pattern is especially suggestive of pulmonary embolism?

Isolated T-wave inversion in aVLT-wave inversion in V1–V3 plus inferior-lead T-wave inversionsT-wave inversion only in V6Diffuse T-wave inversion with severe QT prolongation

6. Which ECG finding may be seen with pulmonary embolism and right ventricular strain?

Sinus tachycardiaRight axis deviationIncomplete RBBBAll of the above

7. A young athletic male has anterior T-wave abnormalities with very high QRS voltage, J-point notching, and concave-upward ST morphology. What is the most likely interpretation?

Benign early repolarization variantWellens syndromeAnterior STEMIBrugada syndrome

8. Which feature favors benign early repolarization rather than true Wellens syndrome?

Very high QRS voltageJ-point notching or fish-hook morphologyConcave-upward ST segment before a steep descent into the T waveAll of the above

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