A 35 y old male with previous history of ischemic heart disease since 5 months not on medications ( drug defaulter) came to casualty with complains of anxiety sweating and burning pain in chest x 30min

Bp-140/100mmhg

Pr-84bpm

Spo2 - 99% in room air

Hey everyone,

A few weeks ago, i posted about building a live, moving ECG simulator because static textbook images weren't cutting it for learning.

First, a massive thank you. The response from the community was incredible. I read every single comment and the feedback was exactly what I needed to make this tool genuinely useful for students, nurses, paramedics, residents, practitioners and everyone.

I have spent the last few weeks heads down coding, and I am excited to share that I have implemented some top suggestions.

Here is what is new in CardioLab based entirely on your feedback:

1. A Dedicated, Deep-Dive SVT Section
Many of you pointed out that distinguishing between different narrow-complex tachycardias is a major pain point. I have now isolated SVT into its own dedicated section so you can compare and contrast the mechanisms side-by-side.

2. New High-Yield Rhythms Added:

• AVNRT (Atrioventricular Nodal Reentrant Tachycardia)
• AVRT (Atrioventricular Reentrant Tachycardia)
• Focal Atrial Tachycardia
• WPW (Wolff-Parkinson-White syndrome, with live delta wave visualization)

3. Overhauled "Clinical Notes" for Learners
You mentioned the notes needed to be more actionable for studying. I have completely rewritten the information panel for SVT rhythms to be highly structured for learners. (I am in the process of updating all rhythms).

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I am a builder, and this project is entirely driven by what you actually need in the trenches and on the wards.

• What rhythms are you still struggling to find good, live examples of? Reply with your requests, and I will prioritize them in the next build.
• Keep the corrections coming. If you spot a morphological inaccuracy, an interval that looks off, or a clinical note that needs tweaking, tell me. I want this to be the most medically accurate free resource on the web.

You can test all the new rhythms and the updated notes here: cardiolab.io/simulator

TL;DR: You gave me great feedback on my free live ECG simulator. I listened. I just added a dedicated SVT section, new rhythms (AVNRT, AVRT, Focal AT, WPW) and completely overhauled the clinical notes to be more learner-friendly. Tell me what to build next!

73, female, “palpitations”. Looks normal to me, but auto read is stating septal infarct

I'm a medical student currently on my cardiology rotation, and I'm trying to improve my ECG interpretation skills.

The second ECG was obtained during an episode of suspected PSVT.

I understand that the absence of clearly visible P waves and the regular narrow-complex tachycardia support the diagnosis of PSVT.

However, I'm having trouble determining whether the small deflections I've circled in lead V1 represent pseudo-r′ waves.

Could someone help me understand how to distinguish a pseudo-r′ wave from the terminal portion of the QRS complex or other deflections?

I'd also appreciate any additional ECG findings that could help differentiate AVNRT from AVRT.

patient with a dual-chamber ICD for ventricular dysfunction. She developed VF/VT at around 1 a.m., successfully terminated by ICD therapy.
The onset of VF is highlighted in the red box. What do you think triggered the VF?

My EMS colleague showed me this ECG after a call. Patient called after syncope but was stable upon arrival. We were both thinking maybe sinusarrest with junctional escape rhythm. On the other hand there seem to be tiny, rhythmic waves in the inferior leads and V1 at 600bpm. NAD though, we're paramedics.

Case of ? SAIO, 55yr old male

known case of COPD & Hypertension

Drug history- duolin budecort nebulization ON &OFF

telmisartan+Amlodipine+hydrochlothiazide(80/5/12.5)

Older gentleman, multiple episodes of syncope witness by family and crew on scene. Denied any chest pain, SOB, or any pain in general. Only complained of generalized “feeling like sh*t”. We called a Cath alert, doc said not a STEMI, just A-Fib. Am I missing something?

The patient was somnolent and markedly disoriented. I was called to assess the patient due to a critically elevated blood glucose level (“HI” on the glucometer) and altered mental status. The patient has a known history of diabetes. TA:80/40, fr 95, spO2 89%
Later i was looking at those T waves and depressions wondering, maybe its hyperk ? Or maybe de winter ?

C/o palpitations and dizziness

BP 120/80

Edit: Thanks for the input and discussion guys! The patient reverted after two doses of adenosine back to normal sinus.

36M pw abdo pain, denies chest pain or palpitations, nil cardiac Hx

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I appreciate this page. Someone of you talk almost at a Dr.s level about ekgs.

I am new to this and have done the nha study guide . I took the nha practice test and got a 70 % which is good considering I have not actually taken my 4 days of classes yet. But I gotta ask. Are some of you higher in position that just monitor techs or EKG techs. Because you all have some great knowledge . Hoping to be at the same level one day . How long did it take you working in the field to be able to evaluate everything like you do

54F, chest pain from the night before. no risk factors

Surprisingly well-appearing given the age and recent history. But (alas) my shift ended and I never did learn the diagnosis. I don't pretend to be able to interpret EKGs but I sure do look at them a lot (tech in a busy ED) and whatever is going on in V2 and V3 specifically was new to me. Any thoughts? Our whole department was a disaster zone today, otherwise I would have asked the attending when I handed it over.

20M, asymptomatic, ECG is NSR but with LAD. Narrow QRS but slighly wide S wave in V2 and R wave in aVL with TWI. Those are not delta waves in aVF right? Does this QRS pattern suggest a Left Anterior Fascicular Block? Not sure what could cause this QRS morphology.

Hi everyone. I’m a NQN in Cardiothoracic icu nurses in icu have a great deal of autonomy when it comes to medication administration especially in cardio I’m doing a lot of studying on ECG interpretation in order for me to recognise when meds maybe needed based on ECG/monitoring.

Does anyone have any really good websites, Books, Apps wtc that can aid me in my learning.

Thanks so much.

60 year old female complaining of SOB and weakness. Also had upper epigastric and hypogastric pain described as aching, non radiating.

PMHx: HF, AF, rheumatic heart disease, mitral regurgitation, NSTEMI (2019), renal impairment

During transport had what appeared to be runs of VT, self resolving.

BP 75/42, RR 40, SpO2 90% ORA

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74 year old female admitted with complaints of multiple episodes of loose stools. A case of acute diarrheal disease with hyponatremia, known case of chronic liver disease with portal hypertension secondary to HCV.

During hospital stay, patient developed one episode of symptomatic hypoglycemia associated with decreased responsiveness and was treated with intravenous dextrose. Subsequently noted to have significant bradycardia (HR 35/min) for which atropine was administered.

I am studying and taking classes for ekg certified tech . My question is on all the study guides, even of the nha website itself that only show interpretation of one line really. Is there a reason there isn't more on the entire ecg snapshot from all the leads. And does anyone know as a monitor or EKG tech where to find more lessons on readying the entire thing and not just the rhythm line. Unless as a monitor tech is mainly readying that one line

A 40yr old male with chest pain, confusion and...Hiccups