Basics & Fundamentals

How the Lewis Lead Can Improve Tachyarrhythmia Diagnosis

A 68-year-old woman presents to the emergency department with palpitations and tachycardia. The following ECG is obtained:

The Approach to Uncovering Hidden STEMI

A 92-year-old man presents to the emergency department with acute chest pain and diaphoresis. The following ECG is obtained:

Case Potpourri: Avoiding AFib Misdiagnosis, Recognizing Mobitz, and Managing Polymorphic V-Tach

A 50-year-old man is brought to the emergency department after successful resuscitation from a witnessed cardiac arrest. EMS was initially called to the scene for chest pain. While on scene,…

A Key Question That Clinches the Diagnosis

A 54-year-old man presents to the emergency department with nausea, vomiting, and lightheadedness. The following ECG is obtained:

Biphasic T Waves in Suspected Acute Coronary Syndrome

A 69-year-old man with PMHx of hypertension and polysubstance abuse presents to the emergency department for evaluation of exertional chest pain that resolves with rest. He is currently asymptomatic. The…

AI Advances in ECG Interpretation: Why Human Expertise Still Matters

2024 EMS Cases Part IV

A 60-year-old man is being transported by EMS to the emergency department for acute chest pain. The following ECG is transmitted prior to arrival as a “CODE STEMI” and brought…

Navigating a Very Abnormal QRS Axis with a Stepwise Approach

A 44-year-old woman presents to the emergency department with vague complaints about shortness of breath. The following ECG is obtained at triage and brought to you for interpretation:

Avoiding Misdiagnosis Through Proper Lead Placement

A 40-year-old man with no known medical problems presents with concerns about his cardiac health after a friend recently had an MI. He has no symptoms of acute coronary syndrome…

Key Points to Note About Complete Heart Block

A 70-year-old woman presents to the emergency department with lightheadedness and dizziness that is worse with standing. The following ECG is obtained:

Key Points to Note About Mobitz I & Mobitz II

A 49-year-old man presents to the emergency department after an episode of syncope. The following ECG is obtained:

Recent UMMC Cases

A 67 -year-old man presents to a busy emergency department with acute chest pain and shortness of breath. The following ECG is obtained, but he leaves without being seen because…

Concerning chest pain with ST segment depression in the anteroseptal leads (Part 2/2)

A 50-year-old woman presents to the emergency department with acute chest pain. The following ECG is obtained on arrival:

Concerning chest pain with ST segment depression in the anteroseptal leads (Part 1/2)

A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain.  Pain is…

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 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….

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…