Basics & Fundamentals

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

ECG Basics & Fundamentals: can young patients have an MI?

HPI: 24-year-old male presents to the ED with chest pain. He has no known cardiac risk factors. Pain is constant for the past hour and he is noted to be…

ECG Basics & Fundamentals: how frequently should you obtain serial ECGs in patients with concern for ACS

HPI: A 65-year-old patient is brought in by EMS for a chest pain history that is concerning for ACS. The following ECG is obtained: Case ECG Before watching this week’s…

ECG Basics & Fundamentals: serial ECGs in a patient with chest pain and a paced rhythm

HPI: A 63-year-old male calls EMS after a syncopal episode. He is found to be alert, but complaining of chest pain that radiates bilaterally and that is associated with diaphoresis….

ECG Basics and Fundamentals: ECG findings in hypothermia

HPI: An elderly woman is found down by EMS early in the morning in Baltimore. Her family reports that was drinking some eggnog the night before at a holiday party….

ECG Basics and Fundamentals: Hypertrophic Cardiomyopathy

HPI:  A 30-year-old female is brought to the ED after a syncopal episode. Her history and physcial exam are unremarkable. The following ECG is obtained: Case ECG Before watching this…

ECG Basics & Fundamentals: reliability of computer interpreted ECGs, can the ECG machine be trusted to get it right?

A 59-year-old man with PMHx of severe hypertension presents to the ED with sharp and positional chest wall pain after a mechanical fall. He denies exertional worsening of pain, or…

ECG Basics & Fundamentals: electrical alternans is present in less than 1/3 of patients with proven cadiac tamponade

A 56-year-old woman with history of breast cancer presents to the ED with chest pain and dyspnea. She is found to be afebrile, tachypneic, and tachycardic with a normal blood…