Three ECG Traps You Cannot Afford to Miss

UMEM Potpourri ECG Cases with Dr. Amal Mattu

HPI

A 60-year-old woman presents with palpitations and an irregular wide-complex tachycardia. The computer calls atrial fibrillation with a left bundle branch block, but a subtle clue in the precordial leads suggests this is more than just an arrhythmia. Sometimes, one lead is enough to diagnose an acute coronary occlusion. Do you see it?

Before watching this week’s workout, review the arrival ECG carefully and consider:

    1. In a patient with AF and LBBB morphology, what ST segment finding in a single lead is enough to diagnose acute coronary occlusion?
    2. What is the significance of ST depression in V1 to V3 when the QRS complex is predominantly negative?
    3. When a wide-complex tachyarrhythmia and ischemia coexist, how do you avoid anchoring on the rhythm and missing the infarct?