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

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 at…

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

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 is…

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…

STAT ECG Diagnoses: Wellens syndrome and pseudo-Wellens waves

HPI: A 33-year-old male with PMHx of HTN is brought in by EMS for intermittent chest pain for the past few days. The patient is now chest pain free and…

ECG Basics & Fundamentals: how frequently should you obtain serial ECGs in patients with concern for ACS

HPI: A 65-year-old patient is brought in by EMS for a chest pain history that is concerning for ACS. The following ECG is obtained: Case ECG Before watching this week’s…

Literature Review: risks of AV nodal blockade in patients with atrial fibrillation with WPW

HPI: A 25-year-old male presents to the ED with chest pain that radiates to the left arm. The pain is associated with diaphoresis and palpitations. The following ECG is obtained:…

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

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:

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….