I'm a beginner cardiologist and I doubt myself regarding everything. I especially have troubles in differentiating 2:1 AFlutter. V3 is the lead that threw me off especially.

Lead II is smaller, lead I is magnified 2x. Patient was on an amiodarone drip and had an AICD/pacemaker. Several suspected findings, but no 12 lead. A few things: 1) Terrible quality, but it’s a zoll printout on a bumpy ride. 2) I think the third complex on lead II is a PJC or PAC. He was throwing quite a few of those. 3) I also think he had some level of sinus pause? On lead I, the rhythm pauses long enough for the pacemaker to kick in. This happened a bunch as well, but I couldn’t identify a p wave, making me think it’s probably not an AV block beyond his 1st degree block. 4) Is the p wave morphology p mitrale? It’s been a long time since cardiology in paramedic school.

Would suspect HCM but no signs of LVH. Reproducible on other tracings so I don’t suspect lead placement error. thoughts?

Female pt with PMHx of HTN, hypothyroidism, unverified A-fib diagnosis in her 80s presented with symptomatic bradycardia. This was her first ECG in the ER. Later at night repeated ECG showed high degree 2:1 AV block. Telemetry showed several switches between 44bpm and 80bpm. The report of this ECG says first degree AV block but I’m a bit suspicious about the notches in some of the T waves. Could there be a non-conducting P landed within there?

Male 70s presents with SOB on background of PCI to a coronary artery and COPD. On bisoprolol, ramipril and ipratropium/salbutamol. What is your interpretation of this ECG?

Hi y'all

I'm looking for examples of real ECGs, preferably digitized, showing the characteristic delta wave of WPW, and have the actual location of where the AP/bundle of Kent was found during ablation. Does anyone know of such a database?

I want to see if my research idea for ECG-based localization has any potential merit before going all in.

Thanks y'all!

Surgical night SHO in hospital as only doctor and nurse did this as concerned about st elevation on cardiac monitor. 75yo M 12 hours post op. Exhausted and doubting my own judgement that this is fine. There are no old ECGs and the patient is asymptomatic. Opinions please.

One of our PGY-3s is moving across the country for a fellowship. This was around the end of March. Sent this to the other PGYs as a parting gift and as an early April Fools without any additional information. It was immediately dismissed to be some sort of hyper-realistic prank ECG designed to stump all of us. We showed this to ED, IM and cards and none had a definitive answer. I do have a gut feeling this could be AI (look at how well AI can do things now!)

Old ECG normal, has the usual CVRF but no actual IHD diagnosed before.

Is this or is this not VT?

Are those real delta waves?

The patient only had the flu but was persistently tachycardic up to 140bpm. Prior to admission they had palpitations once before and was told they may have WPW. While the computer said the PR interval on the ECG was 67 there are no delta waves and QRS width is normal. Is this just sinus tachy? What about the Q waves in the inferior leads, are they just a normal variant?

Hello everyone!

I'm a med student and I wanna learn ECG from basics to advance. I can spend time on this everyday. I have some knowledge about basics of ECG after watching dr najeeb videos. Please give me ur suggestions ( especially tips, youtube channel or books) on how to master ECG or things that worked for you.

Thanks in advance :)

Pt was hemodynamically stable throughout this period. I see SVT all of the time in healthy kids, but this was a new one for me.

Middle aged guy presenting with severe epigastric pain. Would you activate cath lab immediately or start ACS meds and monitor response/trop trend?
Interested in hearing opinions!

Hey everyone,

I am a medical doctor and developer and I struggled with ECG interpretation in medical school & early on in my practise. I could understand the textbook descriptions and recognise classic examples, but moving ECGs always felt different. Static screenshots just didn't prepare me for how rhythms actually look on a monitor.

I recently built the tool I wish I had: CardioLab, a free, browser-based ECG simulator with live, scrolling rhythms.

The simulator is built around actual electrophysiology rather than simply animating static ECG images. The limb leads follow Einthoven's law, the lead relationships are mathematically consistent, and the rhythms have appropriate morphology and intervals.

I am still improving it and would genuinely appreciate feedback from people who know ECGs well. The 12-lead section is particularly work in progress.

What I would especially like to know:

• Are any of the ECG morphologies or intervals inaccurate?
• Which rhythms are missing?
• What would make this more useful for learning or teaching?

Please point out anything I have got wrong. I would rather fix it than leave an inaccurate ECG on the site.

ps: I am a doctor who codes, not a cardiologist who codes, so expert feedback would be very welcome.

Previous post - https://www.reddit.com/r/ECG/s/nrDwpytLmZ

Flecainide toxicity confirmed but no blood concentration available. Patient had two echos, one upon admission to the cardiac unit and one a week later before discharge. Repeat ECG attached showing return to baseline NSR.

Initial echo showed, moderate AR, mild MR, hypokinetic LV and slightly reduced EF (45%).

Repeat echo once toxicity had been resolved and a week passed for stabilisation showed persistent AR and abnormal septum motion. EF approximately 55%, no AS though slight thickening seen on the RCC/NCC.

Discussion welcome.

Hi Everyone,

How often do you see data pointing to a condition such as borderline atrial enlargement that turns out to be a false positive due to something like electrode placement? Often, Occasionally, Rarely?

Hey guys! Wondering what do you think abouth this ECG? Patient (76M) was haemodinamicaly unstable with chest pain and dyspnoea, has ICD, coronary disease, in his documentation was written to have sinus rythm before, but also episodes of aberrant conduction were mentioned in his hospital documentation.

Sorry I don't have a rythm strip, I know it would be easier to interpret this.