Approach to ECGs

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…

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:

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…

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 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 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, Part III

A 55-year-old woman with a history of hypertension, diabetes, and tobacco use presents to the emergency department with chest heaviness and shortness of breath. Her initial ECG raised immediate concern…

2025 EMS Cases Part II

A 57-year-old man is being brought in by EMS for generalized weakness and vomiting. The following ECG is obtained and transmitted as a CODE STEMI alert:

2025 EMS Cases Part I

A 55-year-old woman calls EMS with acute palpitations and chest discomfort. Vitals are normal aside from marked tachycardia. The following prehospital ECG is obtained:

2025 In-Training Exam Preparation (Part III/III)

A 47-year-old male presents to the emergency department with acute chest and back pain. The following ECG is obtained, and concerning for diffuse ST segment elevation:

2024 UMMC Cases (Part I)

A 69-year-old man arrives at the emergency department with shortness of breath and profuse sweating. The ECG obtained below shows sinus tachycardia at a rate of ~ 130 bpm with…

When One Lead Stands Alone: Deciphering Bizarre ECG Abnormalities

A 67-year-old woman with PMHx of HTN, DM, and ESRD presents to the emergency department drowsy and non-cooperative. Her blood sugar is elevated, pH 7.23, and there is concern for…

The Approach to Uncovering Hidden STEMI

A 92-year-old man presents to the emergency department with acute chest pain and diaphoresis. The following ECG is obtained:

A Key Question That Clinches the Diagnosis

A 54-year-old man presents to the emergency department with nausea, vomiting, and lightheadedness. The following ECG is obtained:

AI Advances in ECG Interpretation: Why Human Expertise Still Matters

Navigating a Very Abnormal QRS Axis with a Stepwise Approach

A 44-year-old woman presents to the emergency department with vague complaints about shortness of breath. The following ECG is obtained at triage and brought to you for interpretation:

Avoiding Misdiagnosis Through Proper Lead Placement

A 40-year-old man with no known medical problems presents with concerns about his cardiac health after a friend recently had an MI. He has no symptoms of acute coronary syndrome…