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:

STAT ECG Diagnoses: when to avoid amiodarone

A 45-year-old man presents with nausea and vomiting. He appears dehydrated and reports taking furosemide chronically. Treatment with IV fluids and ondansetron is initiated, and the following rhythm strip is…

ECG Basics & Fundamentals: pseudo ST segment elevation in patients with bundle branch blocks

A 75-year-old man presents with a history that is concerning for ischemic chest pain. The following ECG is obtained:

Literature Review: what do you do when ST-segment elevation in STEMI resolves before cath lab activation

A 49-year-old man presents with chest pain and diaphoresis while riding his bike. His ECG shows inferior and posterior STEMI. After aspirin and nitroglycerin, the patient’s symptoms resolve and the…

STAT ECG Diagnoses: beware the checkmark sign

A 51-year- old woman presents with progressive left wrist pain for the past 2 weeks. She also reports intermittent chest pain, back pain, headache and malaise. The following ECG was obtained…

EMS ECGs: ventricular tachycardia (VT) pearls and pitfalls

A 47-year-old woman is brought in by EMS with intermittent palpitations and lightheadedness. The following prehospital ECG was obtained:

EMS ECGs: don’t trust the ECG computer interpretation…it will fool you!

Differential Diagnoses: LVH with strain pattern vs. acute cardiac Ischemia

A 52-year-old man is brought in by EMS for chest pain. The following prehospital ECG was obtained:

Literature Review: does GERD provoke myocardial ischemia in patients with coronary artery disease?

A 55-year-old man presents to the ED with intermittent chest pain. He describes transient burning sensation that comes on only after eating. His pain does not radiate, and is not…

Literature Review: Wellens syndrome

A 55-year-old man presents to the ED with intermittent chest pain for 4 days. He has no known medical history and smokes 1 pack of cigarettes a day. He is…

Prolonged QTC interval from severe hypokalemia

A 42-year-old woman presents to the ED with a seizure. She has been noncompliant with medications. She is now awake and well, though she appears malnourished. The following ECG was…

ECG Basics & Fundamentals: the ECG must always be interpreted in the context of clinical presentation

A 20-year- old woman presents to the ED with a history of panic disorder complaining of anxiety and palpitations. The following ECG is obtained:

Literature Review: ECG findings in PE associated with hemodynamic instability and increased morbidity and mortality

An 80-year-old man is brought to the ED by EMS for chest pain and dyspnea. He is found to be tachypneic, tachycardic, hypoxic, with a blood pressure of 105/50. The…

2017 ECG Competition Answers (Part 2/2)

  This week we review the answers to questions 7-14 from the 5th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before clicking the red box…

2017 ECG Competition Answers (Part 1/2)

  This week we review the answers to the first 6 questions from the 5th annual UMEM Residency ECG Competition.  Make sure to attempt to answer the questions before clicking the…

ECG Basics and Fundamentals: must knows in patients with ST segment elevation in aVR

An 80-year-old man is brought to the ED by EMS for chest pain and dyspnea. He is found to be tachypneic, tachycardic, hypoxic, with a blood pressure of 105/50. The…

Differential Diagnoses: ST segment elevation in aVR with multilead ST segment depression

A 74-year-old male presents to the ED with 1 day of epigastric pain, vomiting, and profuse watery diarrhea. The following ECG is obtained:

Differential Diagnoses: what do you look for when interpreting the ECG of patients with “new onset seizures”?

A patient with no known past medical history presents to the ED with ischemic chest pain. While waiting to be seen, he is noted to have a generalized seizure and…