STAT ECG Diagnoses: QRS fragmentation and attention to ecopic beats to help diagnose acute cardiac ischemia on the ECG

ECG Weekly Workout with Dr. Amal Mattu


A 78-year-old male with PMHx of HTN and DM presents with chest discomfort and diaphoresis while moving the lawn. The following ECG is obtained:

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

  1. What ECG abnormalities do you notice?
  2. What is QRS complex fragmentation? 
  3. What is the clinical significance of the finding and your suspected diagnosis?