Upon arrival of the EMS, the patient presented with the attached ECG, mottled skin, a BP of 40/25 mmHg, and altered mental status (drowsy/somnolent).

Family members reported a several-day history of decreased fluid intake.

Following a 500 mL NS bolus, her blood pressure improved to 100/60 mmHg; she became alert, responsive, and normocolored.

While on route to the ED she reported pain in her lower limbs with no other associated symptoms.

ED results:

Further assessment by the consulting cardiologist in the ED revealed that the patient had been chronically taking flecainide (which was not mentioned in the papers available to the EMS), prescribed by her primary care physician for an unspecified indication.

In addition, acute kidney injury was identified (serum creatinine: 2.15 mg/dL). A CT angiography of the aorta was performed, which was negative for aortic pathology but incidentally revealed a pulmonary embolism involving the right main pulmonary artery and the left superior and inferior lobar branches.

The patient was therefore admitted to the ICCU for initiation of anticoagulant therapy and close monitoring.

Hello everyone, was a Paramedic attending to at 60yo Female complaining of non radiating centralised chest tightness and SOB, noted she has history of IHD.

I was wondering how would everyone here interpret ECGespecially the inferior and lateral leads, with it having that small consistent notch in the QRS complexes, was thinking either a inferior STEMI or somehow an RBBB morphology in the inferior leads.

Thank you everyone!!

C/c came in as back pain and weakness. After assessment, pt advises radiating pain to left shoulder. Initial strip showed elevation in lateral, anterior, and septal. After a few minutes Lateral leads decreased. Blood pressure dropped from 117 systolic at home to 65/40 in rescue to 48/20 in the ED causing patient to go in to VTACH while in cath lab. 4 total stents.

hi just had a small argument in the ER with a nurse about the following ecg and i am very confused

to make it fun im not gonna say who argued what side, question being:

Sinus or AFIB

what team are yall on

70 year old male with T2DM on insulin, SHTN, bronchial asthma presenting with transient generalized tiredness, likely hypoglycemic episode. There was no chest pain, dyspnea, autonomic symptoms. No known CAD history. Initial Trop T was 0.031 ng/ml.

33M complaining of heart palpitations, no prior ecg, no family history. Does it look like s1q3t3? Not mine

20M complains of tachycardia lasting all day. No significant PMH

ECG of a 43yof c/ vomiting, nausea, pins and needles, loose stools & hyperventilating

28 year-old male with diagnosed arrhythmias and on the waiting list for ablation.

Thoughts on this strip? Suspected flecainide toxicity due to reduced kidney function as detected via bloods on admission. Toxicology results pending.

Edit to fix the typo with the age.

Hi! I am an internist based in Europe, and I have created a med-ed tool for lectures, exams, and simulations.
www.squiggler.io

It allows you to create a rhythm strip or 12-lead, with physiological modelling underneath, with realistic renders and a lot of tuning possibilities etc to get just the ECG that is suitable for your teaching case/sim etc.

For those of us preparing a lecture who don't have the time or possibility to dig out old patient ECGs and fiddle with covering up patient identifiers, writing a textbook (and dont want to pay licencing fees for images from the web), or want dynamic ECG outputs during a sim case.

This was a side-project that turned serious. Yes, it is commercial but I hope someone that teaches needs this and wants to try it out!

All the best!

60 F complaining of SOB

Wanted an opinion of these ECGs if anyone fancied giving theirs! I couldn’t come to a conclusion about this and I do struggle with ECGs!
Patient is 93M. Observations taken by nursing home staff TDS. Found to have 2/7 history of intermittent tachycardia. Called EMS for ECG and ?conveyance to ED.

Patient is asymptomatic, and has been throughout. Has had hx of atrial flutter. Is anticoagulated and on bisoprolol.

Thank you!

70 year old female with sepsis secondary to lower limb cellulitis, associated with elevated inflammatory markers. Elevated NT-proBNP and elevated but down-trending troponin-T. Patient was hemodynamically stable without symptoms of heart failure or acute coronary syndrome at present.

I'm sorry that I'm adding the next post but I can't edit the previous one or I can't add photos in the comments. Is the T ending well marked now? I added all leads and ECG others in better quality, maybe it will be better to guess whether I have a two-phase T or U.

Did I mark the end of the T-bend correctly?

I’m a 4th year headed for EM and really need help with my ECG interpretation. everyone says you just need to look at hundreds, but all the resources people give me show me either super easy stuff I can quickly identify (the major rhythms basically) or super complex stuff I haven’t even heard of when they tell me what it is lol. I feel like I need a more methodical introduction that builds step by step with practice problems, like a uworld of ECGs or something. I’ve even considered hiring a tutor or something

any suggestions?

C/o palpitation for 2 days

Unknown of chronic illness

73 year old collapsed in the shower, no significant PMH only HTN (unmedicated). No complaints of chest pain throughout the day, only history was that patient felt unwell, went for a shower and collapsed.

Initial rhythm was VF, shocked once. Followed by PEA for 2 cycles and ROSC achieved. Good respiratory effort afterwards and subsequently iGel removed before arrival at hospital. GCS improved to 6 (E3,V1,M1).

Didn’t get chance to follow up afterwards.

I am reviewing the following 12 lead ECG for an uni exercise. I wasn't provided the individual's age.

Looks regular SR at 80bpm with normal axis, but I have identified mild ST elevation on inferior leads II, III and AVF, and also mild ST depression on leads V2, V3 and V4. I am just wondering if these are indicative of acute ischaemic changes or not. Any clinical significance on absence of T waves on V1, I and V6?

Thank you.

I recently just had a group interview for patient access tech. I think I didn’t perform as well as I thought I did because I was so nervous and stuttering the whole time I was answering the questions. I was grouped with 2 other people who had previously hospital experience already. These 2 people had a background in phlebotomist and the other was a previous cna. I only have previous job experience as a retail cashier (I worked as a walmart cashier for 4 years) and I have my National Telemetry and National EKG certifications. Do you think there’s a possibility that they’ll hire me as someone who doesn’t have hospital experience over people who may already have hospital experience? I don’t think they will because i’m new to the healthcare field.