Dr. Smith's ECG Blog

Instructive ECGs in Emergency Medicine Clinical Content

Associate Editors:
— Pendell Meyers & Ken Grauer (2018)
— Jesse McLaren & Emre Aslanger (2022)
— Willy Frick (2024) — Sam Ghali (2025)

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Atrial Flutter with Inferior STEMI?


A 40-something year old male presented with tachycardia.

Computer analysis: Atrial Flutter with Inferior ST Elevation MI.

The computer (and physicians!) frequently fails to recognize that the flutter waves alter the baseline and can thus mimic ST elevation.  All ST elevation in this case is due to the flutter waves.

It is even more common that atrial flutter mimics ST depression.  See this case, and this case.

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Polymorphic Ventricular Tachycardia