Rhythm Interpretation
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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 (2024 – Part III/III)
A 63-year-old woman presents to the emergency department with dizziness and syncope. The following ECG is obtained:
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:
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 (2024 – Part I/III)
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…
Wide Complex Tachycardias: precordial concordance and what to do when some leads appear narrow and others appear wide
A 38-year-old man is brought to the emergency department by EMS for palpitations after he is found to be tachycardic. He is noted to be hypotensive with SBP of 70…
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:
Rhythm Interpretation: Ashman phenomenon vs. nonsustained ventricular tachycardia
A 49-year-old woman presents to the ED with palpitations. She is found to be tachycardic on arrival. The following ECG is obtained:
Wide Complex Tachycardias: differentiation between the four different types of ventricular tachycardia & the importance of recognizing arrhythmias in tachy-brady syndromes
A 73-year-old woman is found by family in bed with decreased level of consciousness. She is brought into the ED for evaluation and is found to have bradycardia and episodic…
Wide Complex Tachycardias: review of ventricular rhythms, benign and malignant
A 52-year-old man with PMHx of diabetes presents to the emergency department with chest pain, nausea, vomiting, and cough. He is found to be tachycardic at triage. The following ECG…
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…
Rhythm Interpretation: Sutton’s rule for the best lead to evaluate atrial activity
A patient presents to the emergency department with palpitations and is found to have an irregular rhythm. The following ECG is obtained:
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