An interesting finding, and absence of another, in an intoxicated patient found down
This was a male in his 20s who was found down, intoxicated presumably with an opiate, perhaps methadone. He awoke very slowly with…
Patient presentation is important, and so is R-wave amplitude
Two Histories, One ECG Story number one: An athletic 20-something presents with chest pain and has this ECG at triage: QTc = 362 ms What do…
de Winter’s T-waves evolve into Wellens’ waves
This comes from a paramedic in Hungary named Farkas László: This patient had chest pain that then resolved: There is diffuse ST depression,…
Slightly Peaked T-waves. What is it?
I saw this as I was reading a large a stack of ECGs: What do you think? There is sinus tachycardia. The T-waves are slightly…
An adolescent with trauma, chest pain, and a wide complex rhythm
This case was sent by Dr Avinash Krishnamurthy, a fine emergency medicine resident from Australia Cairns base hospital Case: An…
Should Emergency Physicians be interrupted by ECGs that are read as “Normal” by the computer?
Here was a comment on Facebook about this post: “I was hoping this post would let me off the hook for all those “normal ekg”…
A patient with shortness of breath
This 50-something with a history of alcohol abuse complained of 2 weeks of increasing dyspnea for 2 weeks, with some chest pain and cough.…
Huge ST Elevation in V2 and V3. What is it?
A 30-something presented with methamphetamine use and agitation. He was sedated, then had an ECG as part of his workup: He was…
ST Elevation in I and aVL, with reciprocal ST depression in lead III
This ECG was texted to me with no clinical information: What do you think? Here is my response: “This EKG looks a bit worrisome. …
Chest Pain Diagnosed as Gastroesophageal Reflux
A 50-something male presented to a clinic for one day of intermittent substernal chest and jaw pain. He had had several episodes of pain…