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…

Literature Review: classic STEMI criteria, and the cardiovascular effects of Marijuana

A 32-year-old man presents to the ED with chest tightness, nausea and dyspnea. He has no past medical history or cardiac risk factors, but reports smoking marijuana regularly. The following…

Post-cardiac arrest ECGs: which arrest survivors should get emergent reperfusion therapy?

A 65-year-old man presents to the ED with substernal chest pain that radiated to the back and is associated with nausea. An ECG is obtained on arrival and is interpreted…

Literature Review: limitations of computer interpreted electrocardiograms

Differential Diagnoses: causes of low voltage QRS complexes aside from pericardial effusion

HPI:  A 48-year-old man presents to the ED with malaise of subacute onset. He is mildly tachypneic with clear breath sounds bilaterally. The following ECG is obtained: Case ECG Before…

How to avoid misdiagnosing the most overcalled tachyarrhythmia by physicians and EGC machines

HPI:  A 64-year-old man presents to the ED with nausea and vomiting. He is tachycardic on arrival and the following ECG is obtained: Case ECG Before watching this week’s video,…

Loss of precordial T wave balance

HPI:  A 61-year-old woman presents to the ED with substernal chest pain and dyspnea. Her symptoms improve (but don’t resolve) with nitroglycerin. The following ECG is obtained, with no priors…

Differential Diagnoses: when STEMIs can present with right axis deviation

HPI:  A 57-year-old with PMHx of HTN and cigarette smoking presents to the ED with chest pain and dyspnea. The following ECG is obtained: Case ECG Before watching this week’s…

ECG Basics & Fundamentals: Crochetage pattern of QRS notching in the inferior leads

HPI: A 27-year-old woman was having a routine physical exam performed, when her physician noted a systolic murmur at the left upper sternal border. The following ECG is obtained: Case…

Differential Diagnoses: considerations in patients with right axis deviation (RAD) and T wave inversions

HPI: An 86-year-old male with PMHx of MI, HTN, HLD, COPD, and CVA presents with abrupt onset chest pain, dyspnea, and nausea. Pain started a few hours ago, is non-radiating,…

Risk stratification of acute coronary syndromes (ACS) and differential diagnoses for poor R wave progression

HPI:  A 54-year-old male smoker presents to the ED with intermittent left sided chest pain. Episodes last 5 minutes at a time and are associated with mild dyspnea on exertion….

ECG reveals a can’t miss genetic cause of cardiac syncope

HPI:  A 39-year-old woman with no PMHx was completing a treadmill stress test ordered by her primary care physician, when she had chest pain, palpitations and syncope. The following ECG…

Literature Review: prevalence of acute coronary syndromes in your patients

HPI:  A 27-year-old male with PMHx of IDDM and heat exhaustion presents to the ED with bilateral arm cramping associated with chest and back aches after doing physical labor outdoors….

Differential Diagnoses: three main causes of narrow complex irregular tachycardias

HPI:  A 65-year-old male is brought to the ED with altered mental status. He seems confused and is found to be tachycardic and hypotensive (SBP=75). The following ECG is obtained…

Differential Diagnoses: diffuse ST segment elevation with a focus on left ventricular (LV) aneurysm

HPI:  An elderly gentleman presents to the ED with diarrhea. He has no chest pain or dyspnea, and denies nausea or vomiting. He appears well. The following ECG was obtained…

STAT ECG Diagnoses: “Shark fin STEMI” morphology and what this ECG pattern means!

HPI:  A 59-year-old male presents to the ED with exertional chest pain that resolved on arrival. An ECG (#1) is obtained at triage. While being interviewed by the physician who…

ECG Basics & Fundamentals: ECG signs of acute right strain

ECG Basics & Fundamentals: can young patients have an MI?

HPI: 24-year-old male presents to the ED with chest pain. He has no known cardiac risk factors. Pain is constant for the past hour and he is noted to be…