ECG STAT Diagnoses

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ECG Basics & Fundamentals: how frequently should you obtain serial ECGs in patients with concern for ACS

HPI: A 65-year-old patient is brought in by EMS for a chest pain history that is concerning for ACS. The following ECG is obtained: Case ECG Before watching this week’s…

ECG Basics & Fundamentals: serial ECGs in a patient with chest pain and a paced rhythm

HPI: A 63-year-old male calls EMS after a syncopal episode. He is found to be alert, but complaining of chest pain that radiates bilaterally and that is associated with diaphoresis….

ECG Basics and Fundamentals: ECG findings in hypothermia

HPI: An elderly woman is found down by EMS early in the morning in Baltimore. Her family reports that was drinking some eggnog the night before at a holiday party….

STAT ECG Diagnoses: epsilon waves in patient with syncope

A teenage girl presents to the ED after brief syncope during sports activity. The following ECG is obtained:

Literature Review: outcomes for patients with STEMI presenting with nondiagnostic initial ECGs

A 45-year-old man presents to the ED with 1 hour of chest pain, shortness of breath, and diaphoresis. The following ECG is obtained:

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…

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