ECG Basics & Fundamentals: dynamic ischemic ECG changes in ACS

A 41-year-old male with no past medical history is brought into the ED with bilateral shoulder pain that has been intermittent throughout the day. On arrival the pain is mild,…

ECG findings in hypothermia

A 77-year-old male is brought into the ED after being found unconscious in his home. The following prehospital ECG was obtained and compared to an old normal ECG:

Differential Diagnoses: is this ECG pattern consistent with ACS or is there something else it could be?

A 59-year-old male with a PMHx of a HTN and anxiety presents the ED for progressive dyspnea on exertion over the past few weeks. He denies pain and appears comfortable….

STAT ECG Diagnoses: how would this prehospital rhythm strip change your management?

A 10-year-old male is transported to your ED for recurrent seizures. The following prehospital rhythm strip was obtained:

ECG Basics & Fundamentals: reflux, burping, and improvement with antacids…can’t be cardiac, right?

A 71-year-old man with history of diabetes & HTN presents to the ED with chest discomfort and burping over the past few days. The discomfort has increased over the past…

ECG Basics & Fundamentals: using a systematic approach to identify the cause of ST segment elevation

A 49-year-old man presents to the ED with nausea, lightheadedness, arthralgias and malaise. He appears dehydrated but has an otherwise normal exam. The following ECG is obtained:

What is the cause of these slurred and downsloping ST segments?

A 56-year-old man with PMHx of atrial fibrillation presents to the ED with generalized weakness and near-syncope. He is found to be hypotensive and bradycardic. The following ECG is obtained:

Can the ECG be used to diagnose a specific type of paralysis?

A 68-year-old man with a history of COPD, DM, HTN, A. fib, & CKD presents to the ED with severe weakness and is unable to move his arms or legs….

STAT ECG Diagnoses: a peculiar pattern of ST segment elevation that is high risk for death!

A 64-year-old man with HTN and DM presents to the ED with chest pain that radiates to the right lower neck x 1 week. He also reports difficulty walking and…

Literature Review: appropriate vs inappropriate concordance in LBBB

  HPI:  A 76-year-old woman presents to the ED with chest pain that radiates to the neck, jaw and teeth. The pain is associated with nausea, dyspnea, and diaphoresis. The…

Narrow Complex Tachycardia: inappropriate anticoagulation because of misdiagnosis

A 96-year-old man presents to the ED with a dry skin rash. On review of symptoms the patient reports 1-2 episodes of fleeting chest pain that is sharp. The following…

ECG Basics & Fundamentals: can torsades cause seizures?

A 55-year-old man presents to the ED after a witnessed seizure and is somnolent on arrival. He wakes up enough to mumble answers to a few questions but then becomes…

DIfferential Diagnoses: subtle but deadly causes of syncope to consider

A 56-year-old woman presents to the ED with chest pain and has a syncopal episode prior to arrival. She has a past medical history of hypertension, hyperlipidemia, is a smoker,…

Differential Diagnoses: life threatening causes of syncope

A 31-year-old woman presents to the ED after a syncopal episode. She reports feeling palpations daily for the past 1-2 weeks, but is now asymptomatic and well appearing. The following…

Literature Review: which patients should go to the cath lab for reperfusion emergently? (Part 3/3)

HPI: A 60-year-old male with a history of CAD with a pacemaker presents to the ED with acute chest pain that radiates to the left arm. Pain is worse with…

Literature Review: which patients should go to the cath lab for reperfusion emergently? (Part 2/3)

HPI: A 65-year-old male with PMHx of CAD and LBBB presents to the ED with substernal chest pressure and pain that radiates to the both arms. Pain is worse with…

Literature Review: which patients should go to the cath lab for reperfusion emergently? (Part 1/3)

STAT ECG Diagnoses: post-cardiac arrest and syncope differentials you can’t miss

A 62-year-old male is being transported by EMS to the ED for acute onset chest pressure. He is noted to be hypotensive with a systolic blood pressure in the 50’s….

EMS ECGs: common mimics of acute coronary syndrome (ACS) and STEMI

A 73-year-old male is being transported by EMS to your ED for acute onset chest pain. He has a systolic blood pressure of 80. A prehospital ECG is obtained and…

STAT ECG Diagnoses: post-cardiac arrest and syncope differentials you can’t miss

A 52-year-old African American male with no known past medical history is brought to the ED after resuscitated V. Fib arrest. A post arrest ECG after resuscitation is obtained: