Metabolic Emergencies

Paralysis Unmasked: ECG Clues That Saved the Day

A 45-year-old woman with PMHx of HTN, DM, ESRD (MWF hemodialysis) presents with acute weakness of all extremities. She reports feeling normal and fully functional before going to bed the…

Recent UMMC Cases (Part III)

A 67-year-old man arrives at the emergency department with palpitations. He is noted to be tachycardic at triage and the following ECG is obtained and interpreted as “sinus tachycardia”:

Subtle ECG Changes and Diagnostic Challenges

A 70-year-old male presents to the emergency department with acute chest pain that sounds ischemic in nature. The following baseline ECG, arrival ECG, and repeat ECGs are obtained:

2024 ECG Competition Answers (Part 2/2)

Instructions from Dr. Mattu: In some of the following questions, I’ll ask you for a FULL ECG interpretation/diagnosis. Here’s what I am asking for: SAMPLE QUESTION: A 58 yo M…

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:

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…

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…

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:

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…

Must know ECGs you will see on board exams and have to recognize in real life

A 34-year-old man is brought to the emergency department with delirium and agitation. The following ECG is obtained:

Differential Diagnoses: causes of prolonged QTc intervals with long ST segments

A 48-year-old male is brought in after being found unresponsive on the street. History is otherwise limited. The patient is afebrile and mildly bradycardic with a normal blood pressure. The…

STAT ECG Diagnoses: STEMI mimics and how you can use the QRS axis to clinch the diagnosis in patients with altered mental status

A 46-year-old man presented with pleuritic left sided chest pain. He was found down for an unknown period of time, with suspicion for drug overdose. The following ECG was obtained:

ECG Basics & Fundamentals: causes of prolonged ST segment

A 54-year-old woman presents to the emergency department with generalized weakness and nausea. She is tachycardic but otherwise has normal vital signs. The following ECG was obtained:

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:

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…

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: prolonged QT and himalayan T waves

A 24-year-old man presents to the ED with diarrhea and dehydration. He is diagnosed with salmonella gastroenteritis and is found to have severe electrolyte abnormalities. The following ECG was obtained…

ECG Basics & Fundamentals: the value of ECGs in patients with diabetic ketoacidosis (DKA)