Differential Diagnoses
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Differential Diagnoses: large T waves and prolonged QT intervals
A 40-year-old man presents with palpitations and malaise. Vital signs are within normal limits with a normal temperature. The following ECG is obtained:
STAT ECG Diagnoses: how to use ECG differentials to clinc the diagnosis in patients who are altered and can not provide a reliable history
A 50-year-old woman is found unconscious by a family member this morning. She was last known normal yesterday afternoon. On arrival to the ED she is minimally responsive and only…
STAT ECG Diagnoses: a patient transferred for suspected STEMI, what other etiologies could be causing this ST segment elevation?
A 24-year-old male with past medical history of paraplegia from severe multiple sclerosis is transferred from a nursing home for suspected STEMI. Transfer documentation reports a history of pleuritic chest…
Differential Diagnoses: factors that rule in STEMI in the evaluation of diffuse ST segment elevation
A 60-year-old male presents to the ED with chest pain and mild dyspnea. The following ECG is obtained:
Differential Diagnoses: new right axis deviation and ST segment elevation
A 27-year-old male with no PMHx is brought in by ambulance for right shoulder pain, nausea, and generalized weakness. He is confused with a blood pressure of 60/40. The following…
Differential Diagnoses: interval abnormalities and the importance of not trusting the computer ECG interpretation
A 61-year-old woman presents from a nursing home for G-tube replacement. She reports lightheadedness and appears dehydrated. The following ECG is obtained:
Differential Diagnoses: poor R wave progression and attention to T wave abnormalities
A 55-year-old woman presents with substernal chest pressure radiating to the left upper extremity, dyspnea, and nausea. She has a past medical history of HTN, DM, HLD, and is a…
Differential Diagnoses: terminal QRS distortion in the differentiation of STEMI from early repolarization
A 43-year-old male presents to the emergency department with chest pain. The following ECG is obtained:
Bradydysrhythmias: a differential for too many P waves and a lesson in how to break down difficult rhythms
An 81-year-old female presents to the ED with lightheadedness and “funny heart beats”. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is…
Differential Diagnoses: the many causes of T wave inversions
A 19-year-old female presents to the ED with atypical chest pain. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is obtained:
Differential Diagnoses: altered mental status and a short QT interval
A middle-aged adult presents to the emergency department with altered mental status. He was dropped off in the waiting room by family. He has no known medical history. The following…
Differential Diagnoses: ST segment elevation in aVR
A 53-year-old man presents to the emergency department with syncope. The patient reports abrupt onset of severe, sharp chest/thoracic pain prior to the syncopal episode. The following ECG was obtained…
Differential Diagnoses: a triad of long QT interval, PVCs, & ST segment depression
A 56-year-old woman presents to a busy ED dehydrated with acute gastroenteritis. She is placed in a hallway bed and treated with IV fluids and ondansetron. On reassessment the patient…
Differential Diagnosis: STEMI vs. acute pericarditis
A 45-year-old male presents to the emergency department with sharp, positional, and pleuritic chest pain while doing CrossFit. He is not a smoker and has no known cardiac risk factors….
Differential Diagnoses: causes of low voltage QRS complexes aside from pericardial effusion
HPI: A 48-year-old man presents to the ED with malaise of subacute onset. He is mildly tachypneic with clear breath sounds bilaterally. The following ECG is obtained: Case ECG Before…
Differential Diagnoses: when STEMIs can present with right axis deviation
HPI: A 57-year-old with PMHx of HTN and cigarette smoking presents to the ED with chest pain and dyspnea. The following ECG is obtained: Case ECG Before watching this week’s…
Differential Diagnoses: considerations in patients with right axis deviation (RAD) and T wave inversions
HPI: An 86-year-old male with PMHx of MI, HTN, HLD, COPD, and CVA presents with abrupt onset chest pain, dyspnea, and nausea. Pain started a few hours ago, is non-radiating,…
Risk stratification of acute coronary syndromes (ACS) and differential diagnoses for poor R wave progression
HPI: A 54-year-old male smoker presents to the ED with intermittent left sided chest pain. Episodes last 5 minutes at a time and are associated with mild dyspnea on exertion….
Differential Diagnoses: three main causes of narrow complex irregular tachycardias
HPI: A 65-year-old male is brought to the ED with altered mental status. He seems confused and is found to be tachycardic and hypotensive (SBP=75). The following ECG is obtained…
Differential Diagnoses: diffuse ST segment elevation with a focus on left ventricular (LV) aneurysm
HPI: An elderly gentleman presents to the ED with diarrhea. He has no chest pain or dyspnea, and denies nausea or vomiting. He appears well. The following ECG was obtained…
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