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Literature Review: Sgarbossa criteria in LBBB
A 60-year-old man presents to the ED with midsternal chest pain that does not resolve with aspirin. He is dyspneic and diaphoretic on arrival. The following ECG is obtained:
Differential Diagnoses: a triad of long QT interval, PVCs, & ST segment depression
A 56-year-old woman presents to a busy ED dehydrated with acute gastroenteritis. She is placed in a hallway bed and treated with IV fluids and ondansetron. On reassessment the patient…
ECG Basics and Fundamentals: how many STEMI patients present with nondiagnostic initial ECGs?
HPI: A 52-year-old male with PMHx of HTN & HLD presents to the ED with chest pain and shortness of breath. He looks uncomfortable on exam and is hypertensive. The…
Syncope: Brugada Syndrome
A 33-year-old woman has a syncopal episode while in the bathroom. The following ECG was obtained on arrival to the ED after the episode:
ECG Basics and Fundamentals: does negative troponin ACS still exist?
A 60-year-old male with PMHx of hyperlipidemia presents to the emergency department with midsternal chest pain (tightness), nausea, and diaphoresis. Symptoms have been intermittent, occur with walking and resolve with…
Differential Diagnosis: STEMI vs. acute pericarditis
A 45-year-old male presents to the emergency department with sharp, positional, and pleuritic chest pain while doing CrossFit. He is not a smoker and has no known cardiac risk factors….
Something, that can do anything it wants to the ECG!
A 58-year-old male presents to the emergency department with shortness of breath, vomiting, palpitations, and mild chest discomfort. The following ECG was obtained on arrival:
Wide Complex Tachycardias: when suspected ventricular tachycardia is too wide and too slow
A 56-year-old man with PMHx of HTN, DM, PVD, and ESRD on dialysis presents to the ED with dyspnea. The following ECG was obtained on arrival:
STAT ECG Diagnoses: what to do when advanced life support (ACLS) does not work
A 40-year-old man is brought to the ED moribund with agonal respirations, hypotension (SBP~50) and bradycardia. The following ECG was obtained and ACLS started with no response to atropine or…
Intermittent runs of nonsustained ventricular tachycardia
A 48-year-old man presents to the ED with 3-4 days of palpitations. The patient has a stable blood pressure but is found to have new onset atrial fibrillation with RVR….
ECG findings in severe hypokalemia that may mimic ACS
An 85-year-old woman with PMHx of atrial fibrillation is referred to the ED by her primary care physician who is concerned for cardiac ischemia. The patient has been having epigastric…
How serial ECGs can save lives!
A 49-year-old man is brought in by EMS to the ED with chest pain concerning for cardiac ischemia. The following prehospital ECG was obtained:
EMS ECGs: accelerated idioventricular rhythm (AIVR) in patients with ACS and other critical cases to help you save lives!
A 69-year-old man is brought in by EMS to the ED with chest pain and shortness of breath. No prehospital treatment was rendered. The following prehospital ECG was obtained:
EMS ECGs: respect lead aVL and looks for subtle early signs of cardiac ischemia
A 30-year-old woman is brought in by EMS to the ED with chest pain. The following prehospital ECG is obtained:
The Bix rule in narrow complex tachycardia
A 63-year-old man is brought in by EMS to the ED with palpitations. The following prehospital ECG is obtained:
2018 ECG Competition Answers (Part 2/2)
This week we review the answers to questions 7-12 from the 6th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red box to…
2018 ECG Competition Answers (Part 1/2)
This week we review the answers to the first 6 questions from the 6th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…
A specific tachyarrhythmia with an excellent prognosis
A 79-year-old man presents to the ED with intermittent episodes of decreased level of consciousness. He is placed on continuous 12-lead cardiac monitoring during his evaluation and a monitor alarm…
Wide Complex Tachycardias: the three major types of ventricular tachycardia
A 60-year-old man presents to the ED chest pain concerning for ACS, and a prehospital ECG concerning for inferior STEMI. The following ECG is obtained on arrival to the ED:
STAT ECG Diagnoses: ECG findings that preceed ST segment elevation in acute coronary syndromes
A 70-year-old man presents to the ED with right sided chest pain that radiates to the left. His pain started while running to catch the subway, and is associated with…
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