Differential Diagnoses

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

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 at…

Differential Diagnoses: wide QRS, right axis deviation, tall R wave in V1

A 76-year-old woman presents to the ED with dyspnea and a syncopal episode. History is limited because the patient is listless and confused. The following ECG was obtained:

Differential Diagnoses: can’t miss differentials for patients with chest pain and dyspnea

HPI: An 81-year-old with history of leukemia presents to the ED with dyspnea and pleuritic chest pain. He is tachycardic and tachypneic with clear lung sounds. The following ECG is…

Differential Diagnoses: hyperkalemia as a cause of ST segment elevation mimicking STEMI

Differential Diagnoses: ST segment elevation in aVR

A 74-year-old man presents to the ED for chest pain with exertion for the past 2 hours.  He appears diaphoretic and acutely ill. The following ECG is obtained:

Differential Diagnoses: how hypercalcemia mimics STEMI

A 62-year-old woman presents to the ED with altered mental status. She denies chest pain or dyspnea. The following ECG is obtained:

Differential Diagnoses: LVH with strain pattern vs. acute cardiac Ischemia

A 52-year-old man is brought in by EMS for chest pain. The following prehospital ECG was obtained:

Differential Diagnoses: ST segment elevation in aVR with multilead ST segment depression

A 74-year-old male presents to the ED with 1 day of epigastric pain, vomiting, and profuse watery diarrhea. The following ECG is obtained:

Differential Diagnoses: what do you look for when interpreting the ECG of patients with “new onset seizures”?

A patient with no known past medical history presents to the ED with ischemic chest pain. While waiting to be seen, he is noted to have a generalized seizure and…

Differential Diagnoses: over 15 causes of ST segment elevation…there is much more than STEMI

A 78-year-old woman with Alzheimer’s disease presents to the ED with dehydration and failure to thrive. She denies pain, diaphoresis, or dyspnea. The following ECG is obtained:

Differential Diagnoses: rollercoaster T waves

A 45-year-old woman presents to the ED with lethargy. BP = 100/50, HR = 60, RR= 12 & shallow. Her nurse thought her rhythm looked abnormal on the cardiac monitor…

Differential Diagnoses: must know causes of wide QRS complexes

A 15-year-old girl presents to the ED listless and tremulous. She is unable to provide a reliable history. Her heart rate is around 150 bpm and she is mildly tachypneic…

Differential Diagnoses: a 5 step approach to comprehensive ECG interpretation

A 46-year-old man presents to the ED with generalized weakness and body aches. He is noted to have normal vital signs. The following ECG is obtained:

Post-cardiac arrest ECGs: differential diagnoses to consider when dealing with non-conducted P waves