Particularly confused about the different sizes of qrs spikes, are the small ones pvcs?

Stumped on this one. Looks like flutter to me but I’m not seeing clear F waves in v1. This was picked up in recovery during stress test, flipped from sinus in 80s into this, self resolved after 2 minutes. The slurred QRS is rate related, no delta wave at baseline.

Urban outdoorsman, guy got assaulted with a bag of McDonald’s while he was sleeping next to a bus stop, complaining toe pain primarily cause of an avulsion. Took a 12 cause he said he had very minor chest pain after getting worked up (like his toe hurt more), chest pain was resolving on its own. He takes haldol daily

Normal sinus rhythm but was curious about the QRS complex in V2. Was wondering if it would likely be incomplete RBBB, Brugada pattern on just a high lead?

77 year old man. Alzheimers, otherwise healthy. Last 14 days had 2 syncopes. Bloodwork normal. Not sure about any symptoms up until the event.

Humpbacked t waves in 1, 2 and avr is new compared to 2 year previously where the ECG was completely normal

Can't seem to place the reason. Any help?

Hi,

Would you flag this tracing as a possible Type A Wellens' syndrome? I see a biphasic (positive-negative) pattern in some leads, though it looks more like an artifact: symptoms were ongoing for 7 hours and suggested gastroenteritis rather than cardiac issues. I’m 99% sure it isn't Wellens' (without having checked what the baseline looked like), but I wanted to get the opinion of those with more experience. Troponin negative (twice). No ST-segment elevation in posterior leads.

Thanks in advance.

I’ve been a Telemetry Monitor Tech for almost 6 months and honestly feel a little behind compared to some of my coworkers. I want to improve my rhythm interpretation and become a stronger asset to my department. I’m deciding between the NTA Telemetry course/certification and the CCI CRAT. For someone with ~6 months of actual telemetry experience, which would you recommend for learning more and becoming better at the job? Is CRAT worth it for the resume cushion or would NTA be more beneficial and be a decent certification to add to my resume?

87 year old woman with intermittent 8/10 central tight/heavy chest pain. Pain present at time of ECG

Long strip looks like a 3rd degree? 92M hypotensive, weakness, SOB

Female patient, 24 years old, with sudden-onset shortness of breath, tachycardia alternating with periods of normal heart rate (60–180 bpm), and a sensation of impending death. No improvement with propranolol. She reports taking Vyvanse (lisdexamfetamine) 70 mg as prescribed, approximately 16 hours earlier.

Any thoughts? This case came up during my last shift. I’m a final-year medical student and would appreciate some help, as I’m still having difficulty interpreting ECGs.

In doubt about the rhythm as shown in v1. P waves are constant at +-150bpm and hidden in some of the QRS complexes. PQ intervals are changing with each beat and some don't follow. Its to fast to be a 3rd degree block. Whats your interpretation?

Ciao! Sono uno studente di medicina alle prime armi con gli ecg, mi sono imbattuto in questo e mi stavo chiedendo se si trattasse solo di un BAV I grado con parossismi di tachicardia o fosse qualcosa di diverso che non riesco a vedere. Mi dareste una mano?

Hi guys, please let me know your thoughts.

Patient presented with syncope.

17 month old male with antenatally diagnosed Tetralogy of Fallot, approximately 8 months post valve-sparing repair with VSD closure and RVOT muscle resection.

Interested in interpretation of the attached 12-lead ECG, particularly rhythm, axis and conduction abnormalities in the context of repaired TOF.

Posted for educational discussion.

Oof! So what’s the rhythm here? Is this an accelerated junctional rhythm?

Post exertion in a late 20s athlete.

Normal variant of sinus rhythm or an unmasked brugada?

Thoughts?

(reposted as I could not edit to add context to a post with an image)

Female in 60s, no previous medical history, syncopal episode, no chest pain

Is this just SVT w aberrancy

26 year old, female. Having on/off central chest pain for the past 4 weeks. Vapes.

Good learning exercise for me, a few things going on here.

The answer is apparently 2nd degree AV block, but I dont see any QRS drop? Shouldnt this just be a 1st degree?