Syncope
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ECG Hallucinations: When S1Q3T3 Misleads
A 51-year-old truck driver presents to the ED after a brief syncopal episode at a rest stop. It is the middle of summer, his truck’s air conditioning is not working,…
The Syncope ECG With Too Much P
A 68-year-old man has syncope, then has a second syncopal episode while lying still on a stretcher during evaluation at an outpatient clinic. He is sent emergently to the ED….
Three More ECG Pitfalls That Punish Anchoring Bias
A 51-year-old man with lung cancer presents with shortness of breath and tachycardia. The arrival ECG shows an S1Q3 pattern and seems to support a familiar diagnosis that would normally…
Syncope with High Voltage: The Yamaguchi Pattern
52-year-old man with PMHx of hypertension presents after a witnessed syncopal episode at home. He felt lightheaded while standing to use the bathroom and briefly lost consciousness without seizure activity…
Not Your Usual STEMI: High Voltage and Narrow Q Waves
A 16-year-old male is referred to the emergency department from a primary care clinic with concern for STEMI. He has no known past medical history. At the clinic, he reported…
Bradycardia, STEMI, and a Misleading Rhythm Diagnosis
A 68-year-old woman calls EMS after having a syncopal episode while using the bathroom. She reports associated chest pain over the past day. The following prehospital ECG is obtained:
Unrecognized Killers in Emergency Electrocardiography, Part II
A 46-year-old woman presents after two syncopal episodes associated with palpitations. She reports feeling a rapid heart rate before losing consciousness. She has a few witnessed episodes in the emergency…
T Wave Clues: Uncovering Concealed Conduction Blocks and Arrhythmias
A 58-year-old man presents to the emergency department after an episode of syncope. The following ECG is obtained on arrival and interpreted as “sinus bradycardia”:
2024 UMMC Cases (Part II)
A 55-year-old woman arrives at the emergency department with shortness of breath and is noted to be tachypneic. The following ECG is obtained:
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…
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:
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…
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…
Literature Review: Brugada Syndrome
A 55-year-old man with no significant PMHx (on no medications) presents to the emergency department with right lower quadrant pain. He is afebrile on arrival, with mild sinus tachycardia. He…
Literature Review: Fever and ST segment elevation after syncope
A young woman presents to the ED after a syncopal episode. She hit her chest after falling and has reproducible chest wall tenderness on exam. She is also noted to…
Literature Review: Fever and ST segment elevation after syncope
A young woman presents to the ED after a syncopal episode. She hit her chest after falling and has reproducible chest wall tenderness on exam. She is also noted to…
Literature Review: ST segment elevation after syncope and cardiac arrest
A 22-year-old man with no known significant PMHx presents after syncope. He is asymptomatic on arrival with normal vital signs. History and physical exam is non-diagnostic. While an ECG is…
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