Does response to adenosine rule out ventricular tachycardia?

A 54-year-old man with no PMHx presents to the ED with palpitations. He is noted to be tachycardic but is stable with a normal blood pressure. The following ECG is…

The perfect wide complex tachycardia algorithm…does not exist!

A 55-year-old man presents to the ED with chest tightness and palpitations. He is noted to have dyspnea and diaphoresis with a normal blood pressure. The following ECG is obtained:

Nothing will drop risk to zero in the evaluation of ACS

A 50-year-old man presents to the ED with chest tightness. He is placed in observation and has a treadmill stress test, which was negative. He has another episode of chest…

Age as a cardiac risk factor

A 32-year-old woman presents to the ED with 2 hours of chest pain. She has a history of psychosis and smokes cigarettes. The following ECG is obtained:

ECG Basics & Fundamentals: when does the QRS complex end and the ST segment begin in RBBB

A 67-year-old woman with PMHx of Diabetes is brought in by ambulance for 2 hours of chest pain. At arrival she reports mild associated arm pain. The following ECG is…

ECG Basics & Fundamentals: diagnostic criteria for acute pericarditis

A 38-year-old man presents with mid-sternal, sharp chest pain. The pain is non-radiating, worse when supine, and is not associated with any diaphoresis or vomiting. The following ECG is done:

ECG Basics & Fundamentals: differentials for left and right axis deviation, and how to identify fascicular blocks

2016 ECG Competition Answers (Part 2/2)

This week we review the answers to the last 6 cases from the 4th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before you watch the video! Video…

2016 ECG Competition Answers (Part 1/2)

This week we review the answers to the first 6 cases from the 4th annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions before you watch the video!  Video…

Literature Review: syncope evaluation in a young athlete, a review of normal vs abnormal ECG in athletes

A 22-year-old male college basketball player presents to the ED after a syncopal episode during a late morning practice. Witnesses state that he shook for a few seconds but did…

ECG Basics & Fundamentals: inspecting T waves closely, looking for buried P waves

A 65-year-old man presents to the ED with malaise, cough, and vomiting. The following ECG was obtained:

STAT ECG Diagnoses: Post-cardiac arrest ECG with this pattern, what is the most likely cause of arrest and would you activate the cath lab?

An elderly male with no known past medical history is brought into the ED via EMS s/p cardiac arrest. He was found to be unresponsive with a weak pulse at…

How much ST segment elevation is acceptable in patients with a right bundle branch block

A 75-year-old man presents to the ED with weakness and dyspnea. The following ECG was obtained:

Systolic ejection murmur and notching of the R wave in the inferior leads

A 22-year-old man presents to his PCP for a routine medical exam needed for work. He is asymptomatic with normal vital signs, but a 2/6 systolic ejection murmur is heard…

Differential Diagnoses: prolonged QT and himalayan T waves

A 24-year-old man presents to the ED with diarrhea and dehydration. He is diagnosed with salmonella gastroenteritis and is found to have severe electrolyte abnormalities. The following ECG was obtained…

Sustained vs. nonsustained ventricular tachycardia

A 45-year-old woman presents with 1 week of frequent palpitations. She reports mild dyspnea and lightheadedness without any associated chest pain. She denies using caffeine, alcohol or illicit drugs. Family…

STAT ECG Diagnoses: must know ECG differentials in the evaluation of patients with altered mental status

A young woman presents to the ED unconscious with a GCS of 4. The following ECG was obtained during the initial evaluation:

Cardiac arrest after this ECG: what is the most likely cause?

A 60-year-old man presents to the ED with midsternal chest pain that has been intermittent throughout the day. He collapses on arrival and suffers a cardiac arrest from which he…

Literature Review: when are calcium channel blockers and beta blockers contraindicated in atrial fibillation

A 39-year-old man is being transported to the ED via EMS with palpitations, malaise, and chest pressure for the last 12 hours. EMS reports that the has severe tachycardia with a normal mental…

Differential Diagnoses: supraventricular tachycardia with ST segment elevation in aVR

A 57-year-old woman presents to the ED with palpitations and dyspnea. She has a prior history of having an elevated heart rate but has never been formally diagnosed with any specific tachydysrhythmia. The…