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Subtle ECG Changes and Diagnostic Challenges
A 70-year-old male presents to the emergency department with acute chest pain that sounds ischemic in nature. The following baseline ECG, arrival ECG, and repeat ECGs are obtained:
Shock first and ask questions later?
An elderly woman with a past medical history of hypertension, diabetes, and Parkinson’s disease presents to the ED with hip pain after a fall. Her blood pressure and mental status…
2024 ECG Competition Answers (Part 2/2)
Instructions from Dr. Mattu: In some of the following questions, I’ll ask you for a FULL ECG interpretation/diagnosis. Here’s what I am asking for: SAMPLE QUESTION: A 58 yo M…
2024 ECG Competition Answers (Part 1/2)
Instructions from Dr. Mattu: In some of the following questions, I’ll ask you for a FULL ECG interpretation/diagnosis. Here’s what I am asking for: SAMPLE QUESTION: A 58 yo M…
How to avoid misdiagnosis of irregular rhythms
A 80-year-old woman is referred to the emergency department for suspected rapid atrial fibrillation. The following ECG is obtained on arrival:
Unraveling WPW Syndrome: Challenging Cases and Nuances of Treatment
A 15-year-old male with a history of asthma presents with palpitations while playing football. On arrival, he is found to have a narrow complex regular tachycardia most consistent with SVT….
Wolff-Parkinson-White (WPW) Syndrome with Atrial Fibrillation (Afib)
A 53-year-old man presents to the emergency department with palpitations and lightheadedness. On arrival, he is found to have a wide complex tachycardia and the following ECGs is obtained:
Wolff-Parkinson-White (WPW) Syndrome with Supraventricular Tachycardia (SVT)
A 24-year-old man with past medical history of WPW syndrome s/p ablation presents to the emergency department with palpitations. On arrival, he is found to have a wide complex tachycardia…
Post cardioversion ECG of SVT in patient with palpitations and near syncope
A 29-year-old woman presents to the emergency department with an episode of palpitations and near syncope. She reports several similar episodes in the past that were brief in duration and…
Runs of ventricular tachycardia vs. another phenomenon
A 33-year-old man with a past medical history of atrial fibrillation years ago presents with anxiety and shortness of breath. His blood pressure is normal on arrival but he is…
Interesting Cases from UMMC (2024 – Part III/III)
A 63-year-old woman presents to the emergency department with dizziness and syncope. The following ECG is obtained:
Interesting Cases from UMMC (2024 – Part II/III)
A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:
Sloof Lirpa Sign
A 65-year-old woman presents to the emergency department with an episode of near-syncope. Her ECG shown below is interpreted by the ECG machine, an emergency physician, and a cardiologist as…
Interesting Cases from UMMC (2024 – Part I/III)
A 63-year-old man presents to the emergency department with acute chest pain and an episode of syncope. The following ECG is obtained, and the cath lab is activated for suspected…
Literature Review: Shark Fin or “Triangular” ST segment morphology
A 61-year-old male is brought to the ED with acute substernal chest pain and diaphoresis. The following ECG is obtained:
Literature Review: Resolution of ST elevation on serial ECGs in post cardiac arrest patients
A 64-year-old male is brought to the ED after cardiac arrest. He achieved ROSC after CPR, defibrillation, and epinephrine administration. A post ROSC ECG was immediately obtained by EMS and…
Literature Review: Resolution of ST elevation in STEMI
Paramedics are transporting a middle aged male with chest pain and an obvious inferior STEMI. They arrive to the emergency department and the following ECG is obtained on arrival about…
2024 EM Boards ECG Review (Part II/II)
A 55-year-old man with a known left bundle branch block presents to ABEM general hospital with acute chest pain. Vital signs are normal and his pain is slightly improved with…
2024 EM Boards ECG Review (Part I/II)
A 61-year-old man with a history of atrial fibrillation presents to ABEM general hospital with lightheadedness and palpitations. He is tachycardic but otherwise has normal vital signs. The following ECG…
Literature Review: ST segment elevation, but not in contiguous leads!
A 57-year-old woman presents with chest pain and dyspnea. She is hemodynamically stable and her exam is non-diagnostic. The following ECG is obtained:
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