ECG Basics & Fundamentals: serial ECGs in a patient with chest pain and a paced rhythm

HPI: A 63-year-old male calls EMS after a syncopal episode. He is found to be alert, but complaining of chest pain that radiates bilaterally and that is associated with diaphoresis….

Literature Review: lumen stenosis doesn’t matter in ACS…It’s all about plaque vulnerability!

HPI: A 50-year-old male presents to the ED with concerning chest pain while driving home after an appointment with his cardiologist. He reports having an exercise stress test earlier in…

Differential Diagnoses: wide QRS, right axis deviation, tall R wave in V1

HPI: A 76-year-old woman presents to the ED with dyspnea and a syncopal episode. History is limited because the patient is listless and confused. The following ECG was obtained: Case…

ECG Basics and Fundamentals: ECG findings in hypothermia

HPI: An elderly woman is found down by EMS early in the morning in Baltimore. Her family reports that was drinking some eggnog the night before at a holiday party….

Differential Diagnoses: can’t miss differentials for patients with chest pain and dyspnea

HPI: An 81-year-old with history of leukemia presents to the ED with dyspnea and pleuritic chest pain. He is tachycardic and tachypneic with clear lung sounds. The following ECG is…

ECG Basics and Fundamentals: Hypertrophic Cardiomyopathy

HPI:  A 30-year-old female is brought to the ED after a syncopal episode. Her history and physcial exam are unremarkable. The following ECG is obtained: Case ECG Before watching this…

Literature Review: can the ECG risk stratify for short-term adverse events in severe hyperkalemia?

Differential Diagnoses: hyperkalemia as a cause of ST segment elevation mimicking STEMI

STAT ECG Diagnoses: epsilon waves in patient with syncope

A teenage girl presents to the ED after brief syncope during sports activity. The following ECG is obtained:

Several challenging EMS cases to help you make the diagnosis and save more lives!

A 44-year-old man with PMHx of diabetes is transported to the ED by EMS for lethargy and altered mental status. His finger stick blood glucose measurement read as “high”.  The…

ECG Basics & Fundamentals: reliability of computer interpreted ECGs, can the ECG machine be trusted to get it right?

A 59-year-old man with PMHx of severe hypertension presents to the ED with sharp and positional chest wall pain after a mechanical fall. He denies exertional worsening of pain, or…

Literature Review: outcomes for patients with STEMI presenting with nondiagnostic initial ECGs

A 45-year-old man presents to the ED with 1 hour of chest pain, shortness of breath, and diaphoresis. The following ECG is obtained:

Literature Review: aVR – The forgotten 12th lead

A 55-year-old man with PMHx of end stage renal disease on dialysis presents to the ED for fatigue and pain all over. He denies ischemic chest pain. The following ECG…

Differential Diagnoses: ST segment elevation in aVR

A 74-year-old man presents to the ED for chest pain with exertion for the past 2 hours.  He appears diaphoretic and acutely ill. The following ECG is obtained:

Literature Review: De Winter T waves

A 48-year-old man presents to the ED for chest pressure associated with diaphoresis while riding his bike. The following ECG is obtained during active chest pain:

Literature Review: Wolff-Parkinson-White syndrome with atrial fibrillation

A 50-year-old man is referred from clinic to the ED for chest tightness for the past 3 hours and a presumed new left bundle branch block. He is found to…

ECG Basics & Fundamentals: electrical alternans is present in less than 1/3 of patients with proven cardiac tamponade

A 56-year-old woman with history of breast cancer presents to the ED with chest pain and dyspnea. She is found to be afebrile, tachypneic, and tachycardic with a normal blood…

Differential Diagnoses: how hypercalcemia mimics STEMI

A 62-year-old woman presents to the ED with altered mental status. She denies chest pain or dyspnea. The following ECG is obtained:

Rhythm Interpretation: watch out for pokey T waves

A 62-year-old man presents to the ED with atypical chest pain and shortness of breath. The following ECG is obtained:

STAT ECG Diagnoses: earliest ECG findings of cardiac ischemia

A 78-year-old man is sent to the ED from a primary care clinic for chest pain. The following ECG is obtained: