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…

ECG Basics & Fundamentals: when to get posterior leads

A 70-year-old man presents to the ED with ischemic chest pain. The following ECG is obtained:

Wide Complex Tachycardias: ventricular tachycardia (VT) mimics

HPI:  A 71-year- old woman with PMHx of HTN and “irregular heart rhythm” presents to the ED with weakness, lightheadedness, and occasional palpitations. She does not know the name of her medications…

Post-cardiac arrest ECG: intracranial hemorrhage with elevated ICP

A 36-year-old male is brought to the ED by EMS after PEA cardiac arrest. History is limited but he is known to have visited the hospital one week ago with…

STAT ECG Diagnoses: regular wide complex tachycardia (RWCT) after succinylcholine?

A middle-age man presents to the ED with acute hypoxemic respiratory failure from multilobar pneumonia. He is intubated using etomidate and succinylcholine and noted to have a change in rhythm…