EMS ECGs: what isoelectric baseline should be used to measure ST segment deviation, arrhythmias, hypotension in patients with MI, and more!

Baltimore City EMS Cases with Dr. Amal Mattu


A 54-year-old man presents to the emergency department by EMS with ischemic chest pain and is found to be hypotensive. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself:

  1. What is the heart rate and rhythm?
  2. What is the most likely cause of the hypotension?
  3. What is your diagnosis and how would manage this patient?