ECG STAT Diagnoses

ECG Basics & Fundamentals: electrical alternans is present in less than 1/3 of patients with proven cardiac tamponade

A 56-year-old woman with history of breast cancer presents to the ED with chest pain and dyspnea. She is found to be afebrile, tachypneic, and tachycardic with a normal blood…

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:

STAT ECG Diagnoses: earliest ECG findings of cardiac ischemia

A 78-year-old man is sent to the ED from a primary care clinic for chest pain. The following ECG is obtained:

STAT ECG Diagnoses: when to avoid amiodarone

A 45-year-old man presents with nausea and vomiting. He appears dehydrated and reports taking furosemide chronically. Treatment with IV fluids and ondansetron is initiated, and the following rhythm strip is…

Literature Review: what do you do when ST-segment elevation in STEMI resolves before cath lab activation

A 49-year-old man presents with chest pain and diaphoresis while riding his bike. His ECG shows inferior and posterior STEMI. After aspirin and nitroglycerin, the patient’s symptoms resolve and the…

STAT ECG Diagnoses: beware the checkmark sign

A 51-year- old woman presents with progressive left wrist pain for the past 2 weeks. She also reports intermittent chest pain, back pain, headache and malaise. The following ECG was obtained…

Prolonged QTC interval from severe hypokalemia

A 42-year-old woman presents to the ED with a seizure. She has been noncompliant with medications. She is now awake and well, though she appears malnourished. The following ECG was…

Wide Complex Tachycardias: ventricular tachycardia (VT) mimics

HPI:  A 71-year- old woman with PMHx of HTN and “irregular heart rhythm” presents to the ED with weakness, lightheadedness, and occasional palpitations. She does not know the name of her medications…

Post-cardiac arrest ECG: intracranial hemorrhage with elevated ICP

A 36-year-old male is brought to the ED by EMS after PEA cardiac arrest. History is limited but he is known to have visited the hospital one week ago with…

STAT ECG Diagnoses: regular wide complex tachycardia (RWCT) after succinylcholine?

A middle-age man presents to the ED with acute hypoxemic respiratory failure from multilobar pneumonia. He is intubated using etomidate and succinylcholine and noted to have a change in rhythm…

STAT ECG Diagnoses: new T wave inversion or ST segment depression in aVL

A 66-year-old man presents to the ED with retrosternal chest pain that is associated with nausea. The following ECG is obtained:

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…

Wide Complex Tachycardias: regular wide complex tachycardia (RWCT) vs. regular REALLY wide complex tachycardia (RRWCT)

A 70-year-old male presents to the ED with generalized weakness and dizziness. He is suspected to be in atrial fibrillation with a heart rate of ~ 150 bpm. He is…

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…

EMS Cases: The definition of normal sinus rhythms and so much more!

A 89-year-old woman calls EMS for palpitations. The following ECG is obtained:

Narrow vs. wide complex QRS in patients with complete heart block

A 86-year-old woman presents to the ED with generalized weakness. The following ECG is obtained:

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

Bradyarrhthmias: considerations in unstable patients with discussion on an important causes of refractory bradycardia

 A 42-year-old woman presents to the ED with decreased level of consciousness after a seizure. She has no obvious signs of trauma, and vitals signs are normal except for marked…

Wide Complex Tachycardias: considerations in unstable patients with discussion on an important VT mimic

A 78-year-old woman called EMS for palpitations and mild chest pressure. She was shocked 4 times prior to arrival for a wide complex tachycardia and waxing and waning mental status…