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2019 ECG Competition Answers (Part 2/3)
This week we review the answers to questions 7-11, & 13 from the 7th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…
2019 ECG Competition Answers (Part 1/3)
This week we review the answers to the first 6 questions from the 7th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red…
Acute chest pain in a patient with a known right bundle branch block (RBBB)
A 63-year-old male with multiple cardiac risk factors presents to a busy ED with chest pain. He has normal vital signs and a known right bundle branch block. The following…
Bradydysrhythmias: a differential for too many P waves and a lesson in how to break down difficult rhythms
An 81-year-old female presents to the ED with lightheadedness and “funny heart beats”. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is…
Differential Diagnoses: the many causes of T wave inversions
A 19-year-old female presents to the ED with atypical chest pain. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is obtained:
Syncope: what to consider when the history and physical exam are not suggestive of an etiology
A 20-year-old male presents to the ED after a syncopal episode while playing soccer. He reports feeling dizzy before collapsing. He was seen in the ED a few days ago…
Literature Review: safety of computer interpretation of normal triage electrocardiograms
A 64-year-old male with PMHx of hypertension and hyperlipidemia presents to the ED with chest pain associated with vomiting and shortness of breath. The patient looks sick. The following ECG is…
Wide Complex Tachycardias: when administering the wrong medication can cause a “clean kill”
A young patient is brought to the ED complaining of palpitations and mild shortness of breath. The patient does not appear acutely unstable. The following ECG is obtained:
Narrow Complex Tachycardias: the importance of careful ECG interpretation after cardioversion for tachyarrhythmia
A 15-year-old girl presents is brought to the ED complaining of palpitations and near-syncope. She is found to be tachycardic on arrival and the following ECG is obtained:
Wolff-Parkinson-White: a ventricular preexcitation syndrome
A 16-year-old patient presents to the ED complaining of palpitations and lightheadedness. She reports upper body twitching associated with her palpitations and increased levels of stress and anger recently. The…
Rhythm Interpretation: is the PR interval constant, lengthening, or randomly changing?
A 78-year-old woman presents to the emergency department after an episode of syncope. The following ECG is obtained:
ECG Basics & Fundamentals: ECG findings of dextrocardia
A 22-year-old woman presents to the emergency department with atypical chest pain. Her vital signs are normal. The following ECG is obtained:
Differential Diagnoses: altered mental status and a short QT interval
A middle-aged adult presents to the emergency department with altered mental status. He was dropped off in the waiting room by family. He has no known medical history. The following…
STAT ECG Diagnoses: the most rapid killer in diabetic ketoacidosis (DKA)
A 38-year-old male presents to the emergency department with intermittent chest pain for a few weeks. He has insulin dependent diabetes and a history of noncompliance with medications. He looks…
STAT ECG Diagnoses: criteria for right ventricular myocardial infarction (RVMI)
A 52-year-old male presents to the emergency department with 1 hour of right sided chest pain that woke him up in the middle of the night. Chest pain is associated…
The many causes of ST segment elevation in aVR and a discussion on the ECG findings in severe hypokalemia
A known local alcoholic presents to the emergency department with weakness. The patient has been laying on a mattress in a field for most of the past week. He says…
Differential Diagnoses: ST segment elevation in aVR
A 53-year-old man presents to the emergency department with syncope. The patient reports abrupt onset of severe, sharp chest/thoracic pain prior to the syncopal episode. The following ECG was obtained…
ECG Basics & Fundamentals: causes of prolonged ST segment
A 54-year-old woman presents to the emergency department with generalized weakness and nausea. She is tachycardic but otherwise has normal vital signs. The following ECG was obtained:
Rhythm Interpretation: AV dissociation does not always mean there is a complete heart block
A 64-year-old woman presents to the emergency department with sore throat. The following ECG was obtained at triage:
Rhythm Interpretation: is it possible for a 12-year-old to have complete heart block?
A 12-year-old boy is brought into an emergency department in Oman for chest pain and joint pain. The following ECG is obtained:
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