ECG STAT Diagnoses

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Interesting Cases from UMMC, Part II

A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained:

Sloof Lirpa Sign

A 65-year-old woman presents to the emergency department with an episode of near-syncope. Her ECG shown below is interpreted by the ECG machine, an emergency physician, and a cardiologist as…

Interesting Cases from UMMC, Part I

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…

Literature Review: Shark Fin or “Triangular” ST segment morphology

A 61-year-old male is brought to the ED with acute substernal chest pain and diaphoresis. The following ECG is obtained:

Literature Review: Resolution of ST elevation on serial ECGs in post cardiac arrest patients

A 64-year-old male is brought to the ED after cardiac arrest. He achieved ROSC after CPR, defibrillation, and epinephrine administration. A post ROSC ECG was immediately obtained by EMS and…

Literature Review: Resolution of ST elevation in STEMI

Paramedics are transporting a middle aged male with chest pain and an obvious inferior STEMI. They arrive to the emergency department and the following ECG is obtained on arrival about…

2024 EM Boards ECG Review Part II

A 55-year-old man with a known left bundle branch block presents to ABEM general hospital with acute chest pain. Vital signs are normal and his pain is slightly improved with…

Literature Review: ST segment elevation, but not in contiguous leads!

A 57-year-old woman presents with chest pain and dyspnea. She is hemodynamically stable and her exam is non-diagnostic. The following ECG is obtained:

2024 EMS Cases Part III

A 75-year-old man with PMHx of hypertension on metoprolol is being brought in for 3 days of nausea, vomiting, and weakness. He reportedly appears dehydrated and is found to be…

2024 EMS Cases Part II

A 56-year-old woman is being brought in by EMS for palpitations. The following EMS ECG is obtained and transmitted:

2024 EMS Cases Part I

A 64-year-old man is being brought in by EMS for chest pain and shortness of breath. The following EMS ECG is obtained:

Literature Review: Brugada Syndrome

A 55-year-old man with no significant PMHx (on no medications) presents to the emergency department with right lower quadrant pain. He is afebrile on arrival, with mild sinus tachycardia. He…

Literature Review: Fever and ST segment elevation after syncope

A young woman presents to the ED after a syncopal episode. She hit her chest after falling and has reproducible chest wall tenderness on exam. She is also noted to…

New Year’s Resolution: a patient who is trying to get healthier presents to the ED with this unstable bradycardia

A 50-year-old man decides to get “his life in order” for the new year. He quits smoking, decides to eat healthier, exercise more, and to be more compliant with his…

Christmas Case: Decoding the ECG of a 7-year-old boy with lightheadedness and palpitations

A 7-year-old boy visiting from London is brought into the emergency department for palpitations and lightheadedness. He has a history of prior long bone fractures, walks with crutches, and appears…

Literature Review: ST segment elevation after syncope and cardiac arrest

A 22-year-old man with no known significant PMHx presents after syncope. He is asymptomatic on arrival with normal vital signs. History and physical exam is non-diagnostic. While an ECG is…

Wide Complex Tachycardias: clues to VT mimics when the heart rate is too slow or the QRS complexes are too wide

An unknown aged female is being transported to the emergency department by EMS for altered mental status. She is agitated and slurring words. Vitals: 98/65, RR 24, HR 162.  The…

Wide Complex Tachycardias: precordial concordance and what to do when some leads appear narrow and others appear wide

A 38-year-old man is brought to the emergency department by EMS for palpitations after he is found to be tachycardic. He is noted to be hypotensive with SBP of 70…

Wide Complex Tachycardias: beware the many mimics of ventricular tachycardia

HPI: A 73-year-old woman with PMHx of HTN, DM, HLD presents to the emergency department with 2 days of vomiting, malaise, and indigestion with chest discomfort. The following ECG is…

Wide Complex Tachycardias: using modified ECG leads to distinguish ventricular tachycardia from supraventricular tachycardias (VT vs. SVT)

A 60-year-old man presents to the emergency department with left sided chest pain and lower extremity edema. Initial vitals: HR= 155, BP = 120/96, RR = 22, SpO2 = 90%,…

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