Approach to ECGs

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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…

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:

Concerning chest pain with ST segment depression in the anteroseptal leads (Part 1/2)

A 72-year-old woman with a past medical history of diabetes, coronary artery disease, and heart failure presents to the emergency department with acute onset chest and back pain.  Pain is…

Shock first and ask questions later?

An elderly woman with a past medical history of hypertension, diabetes, and Parkinson’s disease presents to the ED with hip pain after a fall. Her blood pressure and mental status…

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…

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…

STAT ECG Diagnoses: a safe approach to the evaluation of patients with diffuse ST segment elevation

A 24-year-old woman presents to the emergency department with acute chest pain and shortness of breath. Pain is described as progressively worsening substernal chest pressure. She has a history of…

STAT ECG Diagnoses: how to approach and tackle tough dysrhythmias

A 91-year-old woman presents to the emergency department reporting that she is just not feeling well. She is noted to have an irregular rhythm. The following ECG is obtained and…

AV Block Bootcamp (Episode 1/3): differential diagnoses for non-conducted P waves, what you need to know to clinch the diagnosis!

A 78-year-old female presents to the ED with lightheadedness and bradycardia. The following ECG is obtained:

ECG Basics and Fundamentals: A stepwise approach to ECG interpretation and how to use differential diagnoses to make critical clinical diagnoses

A 40-year-old man presents to the ED with altered mental status and appears critically ill. The following ECG is obtained:

Stepwise approach to ECG interpretation: systematic rhythm interpretation in a case of syncope

A 76-year-old male presents to the emergency department after an episode of syncope. He denies a prodrome and has no focal neurological complaints or findings. The following ECG was obtained:

Differential Diagnoses: a 5 step approach to comprehensive ECG interpretation

A 46-year-old man presents to the ED with generalized weakness and body aches. He is noted to have normal vital signs. The following ECG is obtained:

ECG Basics & Fundamentals: A systematic approach to EGC interpretation and using differentials for ST segment elevation

A 61-year-old man presents to the ED with malaise, nausea and lightheadedness. The following ECG is obtained:

ECG Basics & Fundamentals: using a systematic approach to identify the cause of ST segment elevation

A 49-year-old man presents to the ED with nausea, lightheadedness, arthralgias and malaise. He appears dehydrated but has an otherwise normal exam. The following ECG is obtained:

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