Computer Interpreted ECGs

Not Your Usual STEMI: High Voltage and Narrow Q Waves

A 16-year-old male is referred to the emergency department from a primary care clinic with concern for STEMI. He has no known past medical history. At the clinic, he reported…

STEMI Diagnosis: Beyond the Millimeters

A 55-year-old man with PMHx of hyperlipidemia presents to the emergency department with vague chest discomfort. The following ECG is obtained:

When to Default to VT and When to Doubt It

A 64-year-old man presents to the emergency department with palpitations. He was recently found to have an acute MI and is one day s/p RCA stenting. The following ECG is…

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:

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:

Small ECG Changes, Big Clinical Wins: How Repeat ECGs Save Lives

A 64-year-old man with PMHx of hypertension and obesity presents to the emergency department with 2 days of worsening chest pain. Pain is central, intermittent, worsens with exertion, and has…

Recent University of Maryland Medical Center Cases (Part I)

A 67-year-old man presents to the emergency department with chest pain and palpitations. The following ECG is obtained on arrival:

Aslanger’s Pattern and the Limits of Traditional STEMI Criteria

A 76-year-old man presents to the emergency department with shortness of breath, severe weakness, diaphoresis, and confusion. The following ECG is obtained on arrival:

2025 EMS Cases Part II

A 57-year-old man is being brought in by EMS for generalized weakness and vomiting. The following ECG is obtained and transmitted as a CODE STEMI alert:

Respect the T Wave: Early Clues to Cardiac Ischemia

A 54-year-old man presents to the emergency department with chest pain concerning for an acute coronary syndrome. An initial ECG is performed on arrival and appears normal, the following repeat…

2024 UMMC Cases (Part I)

A 69-year-old man arrives at the emergency department with shortness of breath and profuse sweating. The ECG obtained below shows sinus tachycardia at a rate of ~ 130 bpm with…

Case Potpourri: Avoiding AFib Misdiagnosis, Recognizing Mobitz, and Managing Polymorphic V-Tach

A 50-year-old man is brought to the emergency department after successful resuscitation from a witnessed cardiac arrest. EMS was initially called to the scene for chest pain. While on scene,…

AI Advances in ECG Interpretation: Why Human Expertise Still Matters

Timeless ECG Lessons: Revisiting Classic Cases and Life Saving Interpretations

A 37-year-old man with no significant past medical history presents to the emergency department with acute chest pain and shortness of breath after a meal. He suspects he is having…

Subtle ECG Changes and Diagnostic Challenges

A 70-year-old male presents to the emergency department with acute chest pain that sounds ischemic in nature. The following baseline ECG, arrival ECG, and repeat ECGs are obtained:

How to avoid misdiagnosis of irregular rhythms

A 80-year-old woman is referred to the emergency department for suspected rapid atrial fibrillation. The following ECG is obtained on arrival: 

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: 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:

STAT ECG Diagnoses: why you should never trust the computer ECG interpretation, even when it reads “normal ECG”!

A 71-year-old male is being transported to the ED for acute chest pain. The following prehospital EMS ECG is transmitted: