Rhythm Interpretation
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The Wide Complex Rhythm That Fooled Everyone
A 30-year-old woman presents with one hour of chest discomfort and palpitations. On arrival she is borderline but not frankly unstable. The 12-lead shows a fast rhythm that appears wide…
Not All Wide Complex Tachycardias Are What They Seem
A 40-year-old man presents with chest discomfort and shortness of breath. He’s ashen, diaphoretic, and hypotensive at 90/45. The ECG monitor shows a wide-complex regular tachycardia at 135 bpm concerning…
AFib Overdiagnosis: Dangerous Pitfalls and Safer Reads
A patient presents to the emergency department with new-onset palpitations. He is hemodynamically stable but noted to have an irregular rhythm on arrival. The following ECG is obtained and automatically…
Really Wide, Kind of Slow: VT vs. Toxicity
A 78-year-old woman with PMHx of atrial fibrillation presents to the emergency department with generalized weakness. She is noted to be tachycardic on arrival, is known to be on flecainide…
When to Default to VT and When to Doubt It
A 64-year-old man presents to the emergency department with palpitations. He was recently found to have an acute MI and is one day s/p RCA stenting. The following ECG is…
Regularly Irregular Rhythms: Sorting Mobitz from PACs and Other Causes
A 52-year-old woman presents to the emergency department with weakness. The following ECG is obtained:
Grouped Beats: A Subtle AV Block Pitfall
An elderly patient is brought to the emergency department with acute stroke symptoms and the following routine 12-lead ECG is obtained during the patient’s stroke evaluation:
High-Grade AV Block: New Perspectives and Important Clarifications
A 51-year-old man presents to the emergency department via EMS with nausea, vomiting, weakness, severe bradycardia (HR in the 20s), and hypotension (BP 60s systolic). The following ECG is obtained…
Mobitz I or Mobitz II: How to tell the difference
A 79-year-old man is sent to a community hospital for evaluation of bradycardia discovered at his nursing facility. He is ultimately transferred to a tertiary care facility for consideration of…
Bradycardia, STEMI, and a Misleading Rhythm Diagnosis
A 68-year-old woman calls EMS after having a syncopal episode while using the bathroom. She reports associated chest pain over the past day. The following prehospital ECG is obtained:
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 3/3)
This week we review the answers to questions 10-14 from the 13th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video…
2025 ECG Competition Answers (Part 2/3)
This week we review the answers to questions 6-9 from the 13th Annual UMEM Residency ECG Competition. Make sure to attempt to answer the questions yourself before watching the video…
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…
Recent University of Maryland Medical Center Cases (Part III)
A 59-year-old man presents to the emergency department with chest pain and palpitations. The following ECG is obtained on arrival:
Recent University of Maryland Medical Center Cases (Part II)
A 72-year-old woman presents to the emergency department with lightheadedness and near-syncope. The following ECG is obtained on arrival:
Recent University of Maryland Medical Center Cases (Part I)
A 67-year-old man presents to the emergency department with chest pain and palpitations. The following ECG is obtained on arrival:
Optical Illusions and 12-Lead ECGs: How First Impressions Can Mislead
A 42-year-old woman presents to the emergency department with chest pain, shortness of breath, and palpitations. Her blood pressure and mental status are noted to be normal. The following ECG…
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…
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