Differential Diagnoses
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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….
ST Elevation and Biphasic T Waves in a Young Man: Wellens, Anterior STEMI, or Something Else?
A 38-year-old Kenyan man presents to a Haitian clinic with three days of low sternal and epigastric pain radiating to the neck, plus exertional dyspnea while working in a hot…
The Wide Complex Rhythm That Fooled Everyone
A 30-year-old woman presents with one hour of chest discomfort and palpitations. On arrival she is borderline but not frankly unstable. The 12-lead shows a fast rhythm that appears wide…
Not All Wide Complex Tachycardias Are What They Seem
A 40-year-old man presents with chest discomfort and shortness of breath. He’s ashen, diaphoretic, and hypotensive at 90/45. The ECG monitor shows a wide-complex regular tachycardia at 135 bpm concerning…
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 IV)
A 73-year-old man is brought to the emergency department with palpitations. The following ECG is obtained on arrival:
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:
Anterior T Wave Inversions: Benign Variant or Hidden Danger?
A 31-year-old woman presents with chest discomfort that is worse with twisting and lifting. She denies any associated vomiting or worsening pain with exertion. The following ECG is obtained on…
2024 UMMC Cases (Part II)
A 55-year-old woman arrives at the emergency department with shortness of breath and is noted to be tachypneic. The following ECG is obtained:
A Key Question That Clinches the Diagnosis
A 54-year-old man presents to the emergency department with nausea, vomiting, and lightheadedness. The following ECG is obtained:
2024 EMS Cases Part IV
A 60-year-old man is being transported by EMS to the emergency department for acute chest pain. The following ECG is transmitted prior to arrival as a “CODE STEMI” and brought…
Navigating a Very Abnormal QRS Axis with a Stepwise Approach
A 44-year-old woman presents to the emergency department with vague complaints about shortness of breath. The following ECG is obtained at triage and brought to you for interpretation:
Concerning chest pain with ST segment depression in the anteroseptal leads (Part 1/2)
A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain. Pain is…
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:
Interesting Cases from UMMC (2024 – Part I/III)
A 63-year-old man presents to the emergency department with acute chest pain and an episode of syncope. The following ECG is obtained, and the cath lab is activated for suspected…
Must Know ECGs and Differentials in Patients with Acute Chest Pain or Shortness of Breath
A 63-year-old woman is brought to the emergency department by EMS for chest pain and shortness of breath. The following ECG was obtained:
Differential Diagnoses: ST segment elevation in a patient with altered mental status, a stepwise approach
A 60-year-old man with PMHx of pancreatic cancer and prior cerebrovascular accidents presents to the ED with altered mental status. Family is concerned that his symptoms are similar to prior…
Differential Diagnoses: what to consider in patients who have isolated syncope and present asymptomatic
A 26-year-old woman presents to the ED after 2 episodes of lightheadedness and near syncope that lasted 30-60 seconds each. She is now asymptomatic with normal vital signs and a…
Differential Diagnoses: must know cardiac causes of syncope
A 22-year-old man presents to the ED after syncope. He reports walking around and experiencing chest discomfort and shortness of breath prior to the episode. He feels anxious on arrival…
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