Wide Complex Tachycardias: beware the many mimics of ventricular tachycardia

A 73-year-old woman with PMHx of HTN, DM, HLD presents to the emergency department with 2 days of vomiting, malaise, and indigestion with chest discomfort. The following ECG is obtained:

Wide Complex Tachycardias: using modified ECG leads to distinguish ventricular tachycardia from supraventricular tachycardias (VT vs. SVT)

A 60-year-old man presents to the emergency department with left sided chest pain and lower extremity edema. Initial vitals: HR= 155, BP = 120/96, RR = 22, SpO2 = 90%,…

Wide Complex Tachycardias: does response to Valsalva maneuvers or adenosine rule out ventricular tachycardia?

Wide Complex Tachycardias: can ECG algorithms safely rule out ventricular tachycardia in the emergency department?

A 45-year-old man with PMHx of hypertension, obesity, and tobacco use presents to the ED with palpitations. Symptoms have been intermittent throughout the day with an associated episode of syncope….

Differential Diagnoses: ST segment elevation in a patient with altered mental status, a stepwise approach

A 60-year-old man with PMHx of pancreatic cancer and prior cerebrovascular accidents presents to the ED with altered mental status. Family is concerned that his symptoms are similar to prior…

Differential Diagnoses: what to consider in patients who have isolated syncope and present asymptomatic

A 26-year-old woman presents to the ED after 2 episodes of lightheadedness and near syncope that lasted 30-60 seconds each. She is now asymptomatic with normal vital signs and a…

Differential Diagnoses: must know cardiac causes of syncope

A 22-year-old man presents to the ED after syncope. He reports walking around and experiencing chest discomfort and shortness of breath prior to the episode. He feels anxious on arrival…

Rhythm Interpretation: Ashman phenomenon vs. nonsustained ventricular tachycardia

A 49-year-old woman presents to the ED with palpitations. She is found to be tachycardic on arrival. The following ECG is obtained:

5 more challenging cases from UMEM to test your ECG diagnostic skills

A 64-year-old woman presents to the ED with chest discomfort associated with multiple episodes of nausea and vomiting. The following ECG is obtained on arrival:

4 challenging cases from UMEM to test your ECG diagnostic skills

Test Yourself

ECG Basics and Fundamentals: things that can go wrong in leads V1 & V2

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Wide Complex Tachycardias: differentiation between the four different types of ventricular tachycardia & the importance of recognizing arrhythmias in tachy-brady syndromes

A 73-year-old woman is found by family in bed with decreased level of consciousness. She is brought into the ED for evaluation and is found to have bradycardia and episodic…

Wide Complex Tachycardias: review of ventricular rhythms, benign and malignant

A 52-year-old man with PMHx of diabetes presents to the emergency department with chest pain, nausea, vomiting, and cough. He is found to be tachycardic at triage. The following ECG…

Post-cardiac arrest ECGs: evaluation of ischemia, dysrhythmias, and their mimics

A 55-year-old man presents to the emergency department with nonspecific chest pain. 20 minutes into his evaluation he is found to be diaphoretic and unresponsive in cardiac arrest with ventricular…

STAT ECG Diagnoses: recognition of life threatening ECG patterns before sudden cardiac arrest

A 73-year-old woman with past medical history of diabetes mellitus and atrial fibrillation is brought to the emergency department for mild hematemesis. The following ECG is obtained, and the patient…

Differential Diagnoses: must know causes of right axis deviation and wide QRS complexes

A 30-year-old man is pulled over by police for speeding. He begins feeling nauseous and has multiple episodes of vomiting. During transport to the emergency department by EMS he is…

STAT ECG Diagnoses: important considerations in hypotensive patients with acute cardiac ischemia

A 59-year-old man with no significant past medical history presents to the emergency department with chest pain, nausea, and shortness of breath for 1 hour. He appears diaphoretic on arrival…

Differential Diagnoses: poor R wave progression, prolonged QT intervals, and much more

A 53-year-old woman presents to the emergency department with shortness of breath. The following ECG is obtained:

Wide Complex Tachycardias: using old ECGs, Lewis leads, and rabbit ears to distinguish VT from SVT

A 48-year-old woman presents to the emergency department with palpitations. She is noted to be tachycardic at triage. The following ECG is obtained:

STAT ECG Diagnoses: distinguishing STEMI from pericarditis, and the difference between Wellens waves and Wellens syndrome

A 54-year-old man presents to the emergency department with acute sharp chest pain that is positional and pleuritic. The following ECG is obtained: