Metabolic Emergencies
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Baltimore City EMS ECGs: Pitfalls and Mimics (Part 2)
A 54-year-old man presents to the emergency department by EMS with acute shortness of breath. A prehospital ECG triggers a STEMI alert based on the computer interpretation. The tracing shows…
Baltimore City EMS ECGs: Pitfalls and Mimics (Part 1)
A 68-year-old man is brought to the emergency department by EMS with acute chest discomfort. The following prehospital ECG was obtained and shows concave ST elevation across multiple leads. The…
Four ECG Pitfalls That Punish Anchoring Bias
A 43-year-old woman with sharp left-sided chest pain and minimal cardiac risk factors has an initial ECG that is not diagnostic for STEMI. She looks stable, but one feature on…
The Post-Arrest Wide Complex Rhythm That Was Not VT
A 35-year-old woman arrives at the emergency department after a witnessed seizure and brief cardiac arrest with ROSC. Her arrival ECG shows a very wide complex rhythm that the machine…
The Post-Thanksgiving Rhythm You Cannot Miss
A 48-year-old woman presents two days after Thanksgiving with severe weakness, palpitations, and mild chest discomfort. Her ECG appears to show a very wide complex regular tachycardia at 119 bpm.
Recent University of Maryland Medical Center Cases (Part V)
A 67-year-old man presents with profound generalized weakness and inability to move his extremities or get out of bed. He has a history of hypertension, chronic kidney disease, substance use…
Recent University of Maryland Medical Center Cases (Part IV)
A 73-year-old man is brought to the emergency department with palpitations. The following ECG is obtained on arrival:
2025 ECG Competition Answers (Part 1/3)
This week we review the answers to questions 1-5 from the 13th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video…
Unrecognized Killers in Emergency Electrocardiography, Part II
A 46-year-old woman presents after two syncopal episodes associated with palpitations. She reports feeling a rapid heart rate before losing consciousness. She has a few witnessed episodes in the emergency…
Unrecognized Killers in Emergency Electrocardiography
A 42-year-old man presents with fever, cough, shortness of breath, and vomiting. He appears toxic and dehydrated on arrival with suspected severe sepsis from multilobar pneumonia. He is later intubated…
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…
2024 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 (2024 – Part II/III)
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:
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