Bradyarrhythmias: regular vs. irregular P-P intervals

ECG cases from Baltimore City EMS

Differential Diagnoses: new T wave inversions in the anteroseptal leads

Literature Review: how long does it take to incorporate evidence into routine clinical practice, and can the HEART pathway safely reduce cardiac testing in low risk chest pain patients

Before watching this video, ask yourself these questions: How long does it take to incorporate evidence-based therapeutics into routine practice? Can the HEART pathway safely reduce cardiac testing in low…

Differential DIagnoses: low voltage QRS and sinus tachycardia

STAT ECG Diagnoses: inverted U waves

HPI:  A 58-year-old male presents with chest pressure and diaphoresis. The following ECG is done. Case ECG  

Differential Diagnoses: new onset seizures

HPI:  A 33-year-old female presents with new onset seizures. The following ECG is done. Case ECG  

Differential Diagnoses: Non-conducted P-waves (P:QRS > 1)

HPI:  A 92-year-old woman presents to the emergency department with lightheadedness. Case ECG   Before watching this week’s video, ask yourself these questions: Focus on the rate and rhythm, what…

Rhythm Interpretation: a three-step approach to diagnosing AV blocks

HPI:  A 54-year-old woman with PMHx of cardiomyopathy is referred to the ED by her cardiologist who is concerned about an “arrhythmia”. Case ECG   Before watching this week’s video,…

Literature Review: how does basic life support compare to advanced (ACLS) in out of hospital cardiac arrest outcomes, and does availability of prior ECGs improve accuracy of STEMI recognition by paramedics?

Before watching this video, ask yourself these questions: Is noninvasive therapeutic hypothermia safe and efficient? Does availability of a prior ECG improve accuracy of STEMI recognition by paramedics? How does…

ECG Basics & Fundamentals: a systemactic approach to ECG interpretation

HPI:  A 78-year-old male presents to the ED complaining of generalized weakness. Case ECG

Differential Diagnoses: the biggest reason we miss a diagnosis is that we make a diagnosis, and then stop looking

HPI:  An unresponsive 45-year-old male is brought in to your ED by ambulance. His wife found him unconscious at home and called 911. History is otherwise limited. Case ECG  

Literature Review: ECG computer interpretations and review of STEMI criteria

HPI: A 45-year-old male is en route to your hospital by EMS with chest pain. EMS has transmitted this ECG to you from the field, with suspicion of STEMI. Case ECG…

Differential Diagnoses: long QTc interval

HPI: 32-year-old female with PMHx of hyperthyroidism (on carbimazole) presents with jaundice and intermittent palpitations. She has mild RUQ abdominal pain, but is otherwise well. Vitals: HR~100, BP-130/70, RR-18, afebrile. Exam:…

ECG basics and fundamentals: Prehospital STEMI activations with a review of the literature

50-year-old woman with a PMHx of DM and obesity presents with dizziness and sub-acute back pain. She also reports myalgias and anorexia. She denies any associated chest pain, and is…

Literature Review: do we still need to send CK-MBs as a cardiac biomarker?

Before watching this video, ask yourself these questions: Do we still need to send CK-MB’s when testing for ACS? How does conventional troponin (c-TN) compare to high sensitivity troponin (hs-TN)…

ECG Basics & Fundamentals: “just because electrocardiography is a basic skill in medicine, doesn’t mean that our ECG skills should be basic”

HPI: 43-year-old male presents with mid-sternal chest tightness. History is otherwise limited. Vitals: HR-110, otherwise normal vitals. Case ECG

Literature Review: age as a cardiac risk factor, what age is too young to have a myocardial infarction (MI)?

HPI: 25-year-old male smoker presents with left arm and upper back pain. He also has mild epigastric pain, associated with vomiting x 4 episodes. Vitals: HR-100, BP-110/70, RR-22, SpO2-100%, afebrile….

Differential Diagnoses: how to use ECG differentials to clinch the diagnosis in sick patients

HPI: 64-year-old male smoker with a Hx of HTN, DM, COPD presents with lightheadedness and chest tightness. He has had flu like symptoms for the past week, that have been…

ECG Basics & Fundamentals: A stepwise approach to ECG interpretation in patients with chest pain and clinical concern for an acute coronary syndrome (ACS) with pearls and pitfalls in obtaining chest pain histories

HPI: 61 year old male with significant cardiac risk factors presents with chest pain that that radiates down both arms. The pain is exertional and improves with rest. His pain…