Basics & Fundamentals
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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…
Interesting Cases from UMMC (2024 – Part I/III)
A 63-year-old man presents to the emergency department with acute chest pain and an episode of syncope. The following ECG is obtained, and the cath lab is activated for suspected…
Literature Review: Resolution of ST elevation in STEMI
Paramedics are transporting a middle aged male with chest pain and an obvious inferior STEMI. They arrive to the emergency department and the following ECG is obtained on arrival about…
2024 EM Boards ECG Review (Part II/II)
A 55-year-old man with a known left bundle branch block presents to ABEM general hospital with acute chest pain. Vital signs are normal and his pain is slightly improved with…
2024 EM Boards ECG Review (Part I/II)
A 61-year-old man with a history of atrial fibrillation presents to ABEM general hospital with lightheadedness and palpitations. He is tachycardic but otherwise has normal vital signs. The following ECG…
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: 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….
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