Rhythm Interpretation

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EMS ECGs: hypothermia emergencies, accelerated idioventricular rhythm (AIVR), and so much more!

 A 63-year-old male presents to the ED with chest ache, near syncope, and exertional lightheadedness. The following ECG is obtained: 

STAT ECG Diagnoses: what to look for on the ECG after synchronized cardioversion

A 44-year-old male presents to the ED with palpitations and shortness of breath. He is found to have a narrow complex regular tachycardia at 230 bpm. The rhythm is most…

Literature Review: treating dysrrhythmias in pregnant patients

A 25-year-old woman G2P1 with no known PMHx is in full term labor when she experiences palpitations and is noted to be tachycardic. The following ECG is obtained:

STAT ECG Diagnoses: antiarrhythmic considerations in patients with unstable irregular tachydysrrhythmias

A 29-year-old male with no significant known PMHx presents to the ED with palpitations. He is found to be markedly tachycardic on arrival. The following ECG is obtained:

Literature Review: diagnosis of acute coronary occlusion myocardial infarction in patients with ventricular paced rhythms

A 65-year-old woman presents to the ED with chest pain and diaphoresis concerning for an acute coronary syndrome. The following ECG is obtained:

STAT ECG Diagnoses: considerations with the heart rate is way too fast in patients with tachyarrhythmias

A 29-year-old male with no significant known PMHx presents to the ED with palpitations. He is found to be markedly tachycardic on arrival. The following ECG is obtained:

STAT ECG Diagnoses: what exactly is Ashman phenomenon and why does it matter?

A 50-year-old male with PMHx of atrial fibrillation presents to the ED with palpitations. He is found to be tachycardic, and while being treated for suspected atrial fibrillation with RVR,…

ECG Basics and Fundamentals: the value of ignoring the ECG computer interpretation and looking closely at all 12 leads

A 48-year-old female presents to the ED with palpitations and near-syncope. She reports multiple episodes of palpitations in the past that have not been evaluated. The following ECG is obtained:

STAT ECG Diagnoses: intermittent runs of nonsustained ventricular tachycardia vs. aberrant conduction

A 36-year-old male with PMHx of RV failure, pulmonary hypertension, and HFrEF presents to the ED with shortness of breath, palpitations, and cough.  The following ECG is obtained:

STAT ECG Diagnoses: a review of the differentials to consider when dealing with wide complex tachycardias and when antiarrhythmic medications can be harmful

A 41-year-old female is brought into the ED by EMS unresponsive with unknown past medical history. She is found to be febrile, normotensive (126/78), tachycardic (120s-150s), tachypneic (30s with a…

Palpitations with extra beats, a discussion on atrial parasystole

A 17-year-old male with no significant PMHx presents to the ED with palpitations. He has no associated symptoms and is otherwise well. Vital signs are normal, but he is noted…

STAT ECG Diagnoses: knowing what you are looking for when differentiating the different types of regular wide complex tachycardias

A 79-year-old male is brought into the ED by EMS with palpitations and lightheadedness while doing light yardwork. He is found to have a wide complex tachycardia at 155 bpm,…

Rhythm Interpretation: the best lead to use to look for atrial activity, and a discussion on the most over diagnosed tachydysrrhythmia

A 58-year-old male with no significant past medical history presents to the ED with palpitations. The following ECG is obtained on arrival with no prior ECGs available for comparison:

STAT ECG Diagnoses: when to cardiovert narrrow complex irregular tachycardias

A 76-year-old woman presents to the ED with fever and signs of sepsis. She is found to be tachycardic, BP 80/45, RR 24, SpO2 94%, 38ºC. The following ECG is…

Narrow Complex Tachycardia: the maximum achievable sinus heart rate

A 67-year-old woman is brought to the ED by EMS for palpitations. She is found to have a heart rate ~168. Vital signs are otherwise within normal limits aside from…

Wide Complex Tachycardias: What is the Lewis lead and how you can use modified ECG leads to help make the diagnosis

A 60-year-old male presents to the ED with acute chest pain and lower extremity edema. He is noted to be tachycardic on arrival. The following ECG is obtained:

STAT ECG Diagnoses: getting rhythm strips right and knowing when acute intervention is needed

A 66-year-old man is transferred to the ED from an urgent care where he presented for shortness of breath and was diagnosed with heart failure. He was recently discharged s/p…

STAT ECG Diagnoses: the definition of electrical storm and what you need to know about it

A 58-year-old man with PMHx of cardiomyopathy (EF ~30%) presents to the ED with intermittent episodes of palpitations and near syncope. The following ECG was obtained during an episode:

Bradyarrhythmias: what to consider when an unstable bradycardia is not reponding to standard ACLS treatments

A 60-year-old woman presents to the ED with dyspnea on exertion and malaise. She is hypotensive and bradycardic. The following ECG is obtained:

Literature Review: pearls and pitfalls in the ECG diagnosis for ventricular tachycardia

A 45-year-old with no known past medical history presents to the ED with palpitations. She is hemodynamically stable. The following ECG is obtained:

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