ECG STAT Diagnoses

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…

STAT ECG Diagnoses: recognition of life threatening ECG patterns before sudden cardiac arrest

A 73-year-old woman with past medical history of diabetes mellitus and atrial fibrillation is brought to the emergency department for mild hematemesis. The following ECG is obtained, and the patient…

Differential Diagnoses: must know causes of right axis deviation and wide QRS complexes

A 30-year-old man is pulled over by police for speeding. He begins feeling nauseous and has multiple episodes of vomiting. During transport to the emergency department by EMS he is…

STAT ECG Diagnoses: important considerations in hypotensive patients with acute cardiac ischemia

A 59-year-old man with no significant past medical history presents to the emergency department with chest pain, nausea, and shortness of breath for 1 hour. He appears diaphoretic on arrival…

Wide Complex Tachycardias: using old ECGs, Lewis leads, and rabbit ears to distinguish VT from SVT

A 48-year-old woman presents to the emergency department with palpitations. She is noted to be tachycardic at triage. The following ECG is obtained:

STAT ECG Diagnoses: distinguishing STEMI from pericarditis, and the difference between Wellens waves and Wellens syndrome

A 54-year-old man presents to the emergency department with acute sharp chest pain that is positional and pleuritic. The following ECG is obtained:

STAT ECG Diagnoses: right ventricular hypertrophy criteria, electrical alternans vs. respiratory variation, and much more

An ill appearing patient arrives to the emergency department in extremis and history is limited. The following ECG is obtained:

STAT ECG Diagnoses: are ECG abnormalities necessary for the diagnosis of acute pericarditis?

Two separate 50-year-old men present to the emergency department with chest pain. Pain in both patients is described as sharp, pleuritic, and positional. The following ECGs are obtained:

STAT ECG Diagnoses: high left ventricular voltages and ‘dagger like’ Q waves

A 20-year-old man presents with nonspecific chest pain. His history and physical exam are unremarkable. The following ECG is obtained: