ECG STAT Diagnoses

2024 EM Boards ECG Review (Part II/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…

Paralysis Unmasked: Impressive ECGs That Saved the Day

A 45-year-old woman with PMHx of HTN, DM, ESRD (MWF hemodialysis) presents with complete paralysis below the neck. She reports being normal and fully functional before going to bed the…

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

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 obtained:

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%,…

Wide Complex Tachycardias: does response to Valsalva maneuvers or adenosine rule out ventricular tachycardia?

Wide Complex Tachycardias: can ECG algorithms safely rule out ventricular tachycardia in the emergency department?

A 45-year-old man with PMHx of hypertension, obesity, and tobacco use presents to the ED with palpitations. Symptoms have been intermittent throughout the day with an associated episode of syncope….

Wide Complex Tachycardias: differentiation between the four different types of ventricular tachycardia & the importance of recognizing arrhythmias in tachy-brady syndromes

A 73-year-old woman is found by family in bed with decreased level of consciousness. She is brought into the ED for evaluation and is found to have bradycardia and episodic…

Wide Complex Tachycardias: review of ventricular rhythms, benign and malignant

A 52-year-old man with PMHx of diabetes presents to the emergency department with chest pain, nausea, vomiting, and cough. He is found to be tachycardic at triage. The following ECG…

Post-cardiac arrest ECGs: evaluation of ischemia, dysrhythmias, and their mimics

A 55-year-old man presents to the emergency department with nonspecific chest pain. 20 minutes into his evaluation he is found to be diaphoretic and unresponsive in cardiac arrest with ventricular…