Basics & Fundamentals

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 cardiac 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…

ECG Basics & Fundamentals: pseudo ST segment elevation in patients with bundle branch blocks

A 75-year-old man presents with a history that is concerning for ischemic chest pain. The following ECG is obtained:

ECG Basics & Fundamentals: the ECG must always be interpreted in the context of clinical presentation

A 20-year- old woman presents to the ED with a history of panic disorder complaining of anxiety and palpitations. The following ECG is obtained:

ECG Basics and Fundamentals: must knows in patients with ST segment elevation in aVR

An 80-year-old man is brought to the ED by EMS for chest pain and dyspnea. He is found to be tachypneic, tachycardic, hypoxic, with a blood pressure of 105/50. The…

ECG Basics & Fundamentals: when to get posterior leads

A 70-year-old man presents to the ED with ischemic chest pain. The following ECG is obtained:

ECG Basics & Fundamentals: chest pain in young patient with no known cardiac risk factors

A 35-year-old man with no PMHx presents to the ED with dull burning chest pain that radiates to his left arm. The following ECG is obtained:

ECG Basics & Fundamentals: when a T wave inversion in lead aVL matters

A 45-year-old woman presents to the ED with severe heartburn. Her pain is associated with dyspnea and diaphoresis. The following ECG is obtained:

ECG Basics & Fundamentals: electrical cardioversion of an unstable regular wide complex tachycardia

A 50-year-old man is brought to the ED with a regular wide complex tachycardia (RWCT) shown below. He is pain free with a normal blood pressure and mental status. His…

ECG Basics & Fundamentals: A systematic approach to EGC interpretation and using differentials for ST segment elevation

A 61-year-old man presents to the ED with malaise, nausea and lightheadedness. The following ECG is obtained:

ECG Basics & Fundamentals: when does the QRS complex end and the ST segment begin in RBBB

A 67-year-old woman with PMHx of Diabetes is brought in by ambulance for 2 hours of chest pain. At arrival she reports mild associated arm pain. The following ECG is…

ECG Basics & Fundamentals: diagnostic criteria for acute pericarditis

A 38-year-old man presents with mid-sternal, sharp chest pain. The pain is non-radiating, worse when supine, and is not associated with any diaphoresis or vomiting. The following ECG is done:

ECG Basics & Fundamentals: differentials for left and right axis deviation, and how to identify fascicular blocks

ECG Basics & Fundamentals: inspecting T waves closely, looking for buried P waves

A 65-year-old man presents to the ED with malaise, cough, and vomiting. The following ECG was obtained:

ECG Basics & Fundamentals: dynamic ischemic ECG changes in ACS

A 41-year-old male with no past medical history is brought into the ED with bilateral shoulder pain that has been intermittent throughout the day. On arrival the pain is mild,…

ECG Basics & Fundamentals: reflux, burping, and improvement with antacids…can’t be cardiac, right?

A 71-year-old man with history of diabetes & HTN presents to the ED with chest discomfort and burping over the past few days. The discomfort has increased over the past…

ECG Basics & Fundamentals: using a systematic approach to identify the cause of ST segment elevation

A 49-year-old man presents to the ED with nausea, lightheadedness, arthralgias and malaise. He appears dehydrated but has an otherwise normal exam. The following ECG is obtained:

ECG Basics & Fundamentals: can torsades cause seizures?

A 55-year-old man presents to the ED after a witnessed seizure and is somnolent on arrival. He wakes up enough to mumble answers to a few questions but then becomes…

ECG Basics & Fundamentals: typical ECG findings in pediatric ECGs

ECG Basics & Fundamentals: a 5 step approach to ECG interpretation and how to think of differential diagnoses

HPI: A 70-year-old man presents with generalized malaise. He has a history of ESRD and has missed dialysis this week. The following ECG is obtained: Case ECG   Before watching…