Metabolic Emergencies

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)