Rhythm Interpretation

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2024 EMS Cases Part IV

A 60-year-old man is being transported by EMS to the emergency department for acute chest pain. The following ECG is transmitted prior to arrival as a “CODE STEMI” and brought…

Distinction Between AV Dissociation and Complete Heart Block

A 54-year-old man presents to the emergency department with chest pain. The following ECG is obtained:

Key Points to Note About Complete Heart Block

A 70-year-old woman presents to the emergency department with lightheadedness and dizziness that is worse with standing. The following ECG is obtained:

Key Points to Note About Mobitz I & Mobitz II

A 49-year-old man presents to the emergency department after an episode of syncope. The following ECG is obtained:

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…

2024 ECG Competition Answers (Part 1/2)

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…

How to avoid misdiagnosis of irregular rhythms

A 80-year-old woman is referred to the emergency department for suspected rapid atrial fibrillation. The following ECG is obtained on arrival: 

Unraveling WPW Syndrome: Challenging Cases and Nuances of Treatment

A 15-year-old male with a history of asthma presents with palpitations while playing football.  On arrival, he is found to have a narrow complex regular tachycardia most consistent with SVT….

Wolff-Parkinson-White (WPW) Syndrome with Atrial Fibrillation (Afib)

A 53-year-old man presents to the emergency department with palpitations and lightheadedness. On arrival, he is found to have a wide complex tachycardia and the following ECGs is obtained:

Wolff-Parkinson-White (WPW) Syndrome with Supraventricular Tachycardia (SVT)

A 24-year-old man with past medical history of WPW syndrome s/p ablation presents to the emergency department with palpitations. On arrival, he is found to have a wide complex tachycardia…

Post cardioversion ECG of SVT in patient with palpitations and near syncope

A 29-year-old woman presents to the emergency department with an episode of palpitations and near syncope. She reports several similar episodes in the past that were brief in duration and…

Runs of ventricular tachycardia vs. another phenomenon

A 33-year-old man with a past medical history of atrial fibrillation years ago presents with anxiety and shortness of breath. His blood pressure is normal on arrival but he is…

Interesting Cases from UMMC, Part III

A 63-year-old woman presents to the emergency department with dizziness and syncope. The following ECG is obtained:

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:

Sloof Lirpa Sign

A 65-year-old woman presents to the emergency department with an episode of near-syncope. Her ECG shown below is interpreted by the ECG machine, an emergency physician, and a cardiologist as…

Interesting Cases from UMMC, Part I

A 63-year-old man presents to the emergency department with acute chest pain and an episode of syncope. The following ECG is obtained, and the cath lab is activated for suspected…

2024 EMS Cases Part III

A 75-year-old man with PMHx of hypertension on metoprolol is being brought in for 3 days of nausea, vomiting, and weakness. He reportedly appears dehydrated and is found to be…

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…

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…

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