Basics & Fundamentals
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ECG Basics and Fundamentals: the earliest evidence of cardiac ischemia on the ECG and when to obtain serial ECGs
A 68-year-old man is brought into the emergency department for acute chest pain radiating to the back. He appears very uncomfortable and is hypertensive on arrival. A CT angiogram is…
ECG Basics and Fundamentals: T wave inversions and the importance of precordial lead placement
A 32-year-old female with a PMHx of obesity and tobacco use presents to the emergency department with 1 day of sharp midsternal chest pain. Pain is intermittent, non-radiating, and associated…
ECG Basics and Fundamentals: subtle early signs of acute cardiac ischemia
A 57-year-old man presents to the emergency department with chest pain concerning for MI. The following ECG is obtained with no prior ECGs available for comparison. Cardiology is contacted and…
ECG Basics and Fundamentals: PR segment or TP? the isoelectric baseline you should use to measure ST segment deviation
A 45-year-old woman presents to the ED with severe chest pain. She is minimally cooperative when trying to obtain a history and is requesting pain medication for severe pain. Physical…
ECG Basics & Fundamentals: reliability of computer interpreted “Normal ECG” by the ECG machine
A 64-year-old man with PMHx of HTN and HLD presents to a busy ED with chest pain, shortness of breath, and nausea. There is no immediate bed availability in the…
ECG Basics and Fundamentals: a condition that is commonly misdiagnosed at polymorphic ventricular tachycardia (PMVT), torsades de pointes, and ventricular fibrillation
A 55-year-old woman presents to the ED with mild to moderate COVID pneumonia. She reportedly had a syncopal episode while on a bed pan. The following rhythm strip was obtained…
STAT ECG Diagnoses: the basics of left bundle branch blocks (LBBB) and how to identify occlusion MI in these patients
A 65-year-old man presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:
ECG Basics and Fundamentals: the value of ignoring the ECG computer interpretation and looking closely at all 12 leads
A 48-year-old female presents to the ED with palpitations and near-syncope. She reports multiple episodes of palpitations in the past that have not been evaluated. The following ECG is obtained:
ECG Basics and Fundamentals: limb lead reversal
A 82-year-old woman presents to the ED “not feeling well”. She reports malaise, mild dyspnea, but denies any pain. Vital signs are normal. The following ECG is obtained on arrival…
ECG Basics and Fundamentals: the isoelectric baseline used to evaluate ST segment deviation
A 45-year-old woman presents to the ED with severe chest pain. She is minimally cooperative when trying to obtain a history and is requesting pain medication for severe pain. Physical…
ECG Basics and Fundamentals: the basics of left bundle branch block (LBBB) and how to diagnose acute coronary occlusion myocardial infarction in these patients
A 65-year-old man presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:
ECG Basics and Fundamentals: normal pediatric ECGs and how they differ from normal adult ECGs
A 6-year-old female is brought into the ED for chest pain. The following ECG was obtained:
STAT ECG Diagnoses: left bundle branch block (LBBB) basics and expected findings with a focus on how to diagnose acute coronary occlusion myocardial infarction in these patients
A 85-year-old woman with a known history of LBBB presents to the ED with chest pain concerning for acute ischemia. The following ECG is obtained:
ECG Basics & Fundamentals: how reliable are reciprocal changes in the diagnosis of STEMI and identication of acute coronary occlusion MI?
A 35-year-old man is brought into the ED by ambulance for chest pain. The following prehospital ECG is obtained:
ECG Basics & Fundamentals: cardiac rhythm strips and how to identify the three main types of ventricular tachycardia
A 58-year-old woman with PMHx of HTN and polysubstance abuse presents to the ED after a syncopal episode. She has been having nausea, vomiting, and diarrhea. She is noted to…
ECG Basics & Fundamentals: ventricular rhythms to be aware of in patients with cardiac ischemia
A 50-year-old man presents to the ED with ischemic chest pain concerning for acute MI. During his work up and observation, he clinically improves but is noted to have a…
ECG Basics & Fundamentals: how common is artifact?
A 72-year-old man presents to the ED with near-syncope. During his evaluation he has a 20-second run of the following rhythm captured on 12-lead ECG monitoring:
ECG Basics & Fundamentals: new tall upright T waves in lead V1
A 53-year-old woman with PMHx of HTN and DM presents with atypical chest pain. She is noted to have a completely normal baseline ECG. The following ECG is obtained:
ECG Basics and Fundamentals: right axis deviation differential and ST segment elevation in rightward leads
A 48-year-old woman presents to the ED with chest pain and near syncope. The following ECG is obtained:
ECG Basics and Fundamentals: A stepwise approach to ECG interpretation and how to use differential diagnoses to make critical clinical diagnoses
A 40-year-old man presents to the ED with altered mental status and appears critically ill. The following ECG is obtained:
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