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

A 30-year-old female is brought to the ED after a syncopal episode. Her history and physical exam are unremarkable. The following ECG is obtained:

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:

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…