Bradyarrhythmias
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UMMC Cases Part II: Grouped Beats, Slow VT, and Diffuse ST Elevation
A 63-year-old man presents with shortness of breath. His ECG shows an unusual rhythm with repetitive groups of two beats separated by pauses.
UMMC Cases Part I: Three ECGs That Reward a Second Look
A 62-year-old man presents with chest pain during a busy emergency department shift. His triage ECG is interpreted by the computer as showing ST-segment depression and possible ischemia. The tracing…
Three High Risk ECGs and the Right Next Move
A 34 year old man presents with acute chest pain radiating to the left arm associated with diaphoresis. He has hyperlipidemia and a family history of early coronary disease. The…
The Cath Lab Was Activated, But Something Didn’t Fit
A 70-year-old woman with CHF, COPD, intermittent atrial fibrillation, chronic pain medication use, and recent poor intake develops sudden dyspnea at rest and is found somnolent and bradycardic in the…
UMEM Cases, Part 4: When the Computer Misses the Rhythm and Flutter Fakes a STEMI
A 44-year-old man with severe cardiomyopathy, an LVAD, chronic amiodarone therapy, and an AICD presents with palpitations. His ECG shows a regular wide-complex tachycardia, but the rate is only 135….
UMEM Cases, Part 3: When the Diagnosis Seems Clear and When It Is Not
A 71-year-old man presents with shortness of breath, and his ECG is initially read as a junctional rhythm. On later review, it is even mistaken for atrial fibrillation. But the…
The Syncope ECG With Too Much P
A 68-year-old man has syncope, then has a second syncopal episode while lying still on a stretcher during evaluation at an outpatient clinic. He is sent emergently to the ED….
Baltimore City EMS ECGs: Pitfalls and Mimics (Part 2)
A 54-year-old man presents to the emergency department by EMS with acute shortness of breath. A prehospital ECG triggers a STEMI alert based on the computer interpretation. The tracing shows…
Regularly Irregular Rhythms: Sorting Mobitz from PACs and Other Causes
A 52-year-old woman presents to the emergency department with weakness. The following ECG is obtained:
Grouped Beats: A Subtle AV Block Pitfall
An elderly patient is brought to the emergency department with acute stroke symptoms and the following routine 12-lead ECG is obtained during the patient’s stroke evaluation:
High-Grade AV Block: New Perspectives and Important Clarifications
A 51-year-old man presents to the emergency department via EMS with nausea, vomiting, weakness, severe bradycardia (HR in the 20s), and hypotension (BP 60s systolic). The following ECG is obtained…
Mobitz I or Mobitz II: How to tell the difference
A 79-year-old man is sent to a community hospital for evaluation of bradycardia discovered at his nursing facility. He is ultimately transferred to a tertiary care facility for consideration of…
Bradycardia, STEMI, and a Misleading Rhythm Diagnosis
A 68-year-old woman calls EMS after having a syncopal episode while using the bathroom. She reports associated chest pain over the past day. The following prehospital ECG is obtained:
Recent University of Maryland Medical Center Cases (Part V)
A 67-year-old man presents with profound generalized weakness and inability to move his extremities or get out of bed. He has a history of hypertension, chronic kidney disease, substance use…
Recent University of Maryland Medical Center Cases (Part IV)
A 73-year-old man is brought to the emergency department with palpitations. The following ECG is obtained on arrival:
2025 ECG Competition Answers (Part 3/3)
This week we review the answers to questions 10-14 from the 13th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video…
2025 ECG Competition Answers (Part 2/3)
This week we review the answers to questions 6-9 from the 13th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video…
Recent University of Maryland Medical Center Cases (Part III)
A 59-year-old man presents to the emergency department with chest pain and palpitations. The following ECG is obtained on arrival:
Recent University of Maryland Medical Center Cases (Part II)
A 72-year-old woman presents to the emergency department with lightheadedness and near-syncope. The following ECG is obtained on arrival:
T Wave Clues: Uncovering Concealed Conduction Blocks and Arrhythmias
A 58-year-old man presents to the emergency department after an episode of syncope. The following ECG is obtained on arrival and interpreted as “sinus bradycardia”:
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