Rhythm interpretation: when to worry about cardiac rhythm strips

ECG Weekly Workout with Dr. Amal Mattu


 A 61-year-old man presents to the emergency department with acute chest pain associated with diaphoresis and appears pale. While obtaining a history and performing a physical exam the patient has a witnessed cardiac arrest with ventricular fibrillation. The following ECG was obtained on arrival:

Before watching the video, look closely at this ECG and ask yourself:

  1. What ECG abnormalities do you notice?
  2. Assuming the patient has a right bundle branch block at baseline, do you see any evidence of acute ischemia or STEMI?