Basics & Fundamentals

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:

ECG Basics & Fundamentals: interval abnormalities can cause clinical uncertainty

A 40-year-old man presents with concerning chest pain. The following ECG is obtained:

ECG Basics & Fundamentals: normal and expected findings in right bundle branch block (RBBB) vs patients with occlusion MI

A 61-year-old male with PMHx of atrial fibrillation on anticoagulation presents to the ED with chest pain for 1 day after eating beef stew. He is concerned about having bad…

ECG Basics and Fundamentals: expected ECG findings in right ventricular (RV) paced rhythms

 A 71-year-old male with PMHx of hypertension and pacemaker placement presents to the ED with chest pain, nausea, diaphoresis, and shortness of breath. The following ECG is obtained:

ECG Basics & Fundamentals: low voltage QRS complexes and sinus tachycardia

A 50-year-old woman has a syncopal episode as she is walking into her oncologist’s office. After her episode she states she feels unwell and has vague discomfort. The patient is…

ECG Basics & Fundamentals: criteria for low voltage QRS complexes and poor R wave progression

A 42-year-old male presents to the emergency department with midsternal chest pressure. He has no past medical history or risk factors. The following ECG is obtained:

ECG Basics & Fundamentals: Hyperacute T waves

A 59-year-old male presented to the emergency department with chest pain. The following ECG is obtained:

ECG Basics & Fundamentals: the ECG findings of hypothermia

An 80-year-old male with a history of HTN, atrial fibrillation and an unknown “kidney problem” presents to the ED after being found unresponsive at home by his son. He was…

ECG Basics & Fundamentals: ECG findings of dextrocardia

A 22-year-old woman presents to the emergency department with atypical chest pain. Her vital signs are normal. The following ECG is obtained:

ECG Basics & Fundamentals: causes of prolonged ST segment

A 54-year-old woman presents to the emergency department with generalized weakness and nausea. She is tachycardic but otherwise has normal vital signs. The following ECG was obtained:

ECG Basics & Fundamentals: respect the T waves!

A 29-year-old male presents to the emergency department with a mild headache and dyspnea. He is an avid cyclist who biked 40 miles the day before. His exam is normal….

ECG Basics & Fundamentals: the sensitive vs. specific definitions for low voltage QRS complexes and differentials that cause them

A 66-year-old woman presents to the emergency department with a few days of midsternal chest pain that is sharp and non-radiating. She is noted to have mild dyspnea on exertion…

ECG Basics and Fundamentals: how many STEMI patients present with nondiagnostic initial ECGs?

HPI:  A 52-year-old male with PMHx of HTN & HLD presents to the ED with chest pain and shortness of breath. He looks uncomfortable on exam and is hypertensive. The…

ECG Basics and Fundamentals: does negative troponin ACS still exist?

A 60-year-old male with PMHx of hyperlipidemia presents to the emergency department with midsternal chest pain (tightness), nausea, and diaphoresis. Symptoms have been intermittent, occur with walking and resolve with…

ECG Basics & Fundamentals: Crochetage pattern of QRS notching in the inferior leads

HPI: A 27-year-old woman was having a routine physical exam performed, when her physician noted a systolic murmur at the left upper sternal border. The following ECG is obtained: Case…

ECG Basics & Fundamentals: ECG signs of acute right strain