About Jesse McLaren

Dr. Jesse McLaren (@ECGcases), is an Emergency Physician in Toronto with a special interest in emergency cardiology quality improvement and education. He is an Assistant Professor at the University of Toronto.

ECG Cases 37 ECG interpretation in electrolyte emergencies

While most of us have a clear algorithm in our minds for the management of life-threatening hyperkalemia, the same may not be said about the other life-threatening electrolyte abnormalities. In this ECG Cases blog Dr. Jesse MacLaren gives us an approach to potassium, calcium and magnesium abnormalities including risk factor assessment, ECG interpretation and management pearls...

ECG Cases 36 – PACER Mnemonic for Approach to Pacemaker Patients

In this month's ECG Cases blog Dr. McLaren explains the PACER mnemonic approach to patients with pacemakers: Pacemaker spike: is it appropriately presence/absent, is there pacemaker-mediated tachycardia (apply magnet) or is there failure to pace (apply magnet to stop sensing, cardio consult)? Aware (sensing): is it normal, is there oversensing (underpacing: apply magnet) or undersensing (treat reversible causes, cardio consult). Capture: if there are pacemaker spikes is there capture, or failure to capture (treat reversible causes, cardio consult). ECG 12 lead: are there signs of hyperkalemia (extra wide QRS, peaked T) or Occlusion MI (Modified Sgarbossa Criteria) that need immediate treatment. Rest of patient: is there a complication of pacemaker insertion related to the pocket (hematoma, infection), lead (pneumothorax, DVT), or heart (pericardial perforation), or is there an emergency unrelated to the pacemaker (eg dehydration, sepsis, GI bleed)...

ECG Cases 35 – ECG Approach to Takotsubo Syndrome

Takotsubo Syndrome is usually triggered by an emotional or physical stress leading to acute catecholaminergic myocardial stunning. The initial ST elevation phase of Takotsubo Syndrome mimics Occlusion MI, can not be distinguished by patient factors or POCUS findings, and requires immediate angiogram. The subsequent phase of Takotsubo Syndrome has T wave inversion in an apical distribution, which can mimic reperfusion, but often has very deep T wave inversions and a very long QT interval. Takotsubo Syndrome is a retrospective diagnosis of exclusion—with an angiogram ruling out occlusion, a ventriculogram showing apical ballooning, and a follow up echo showing recovery of LV function. Complications of Takotsubo Syndrome include LV failure, apical thrombus, and polymorphic VT from long QT. Jesse McLaren guides us through 10 ECGs to elucidate these important take home points...

ECG Cases 34 – ECG Interpretation in Aortic Dissection

Which patients with ECG evidence of coronary occlusion require a CT scan to rule out aortic dissection? What are the range of ECG findings in acute aortic dissection and how do they change management? Dr. Jesse McLaren guides us through 9 cases to answer these and other questions on ECG interpretation in aortic dissection...

ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management

Jesse McLaren guides us through 7 cases and explains his 3-step approach to diagnosing and managing Brugada syndrome in this month's ECG Cases blog...

ECG Cases 32 Prehospital ECG pearls and pitfalls

In this ECG Cases blog we review 8 cases of patients with prehospital ECGs and explore prehospital ECGs for diagnosing STEMI, Occlusion MI, false STEMI, code STEMI, dynamic ischemic changes, truncated voltages. Can you avoid the pitfalls and spot the pearls that help to make the diagnosis?

ECG Cases 31 Is a 15 lead ECG better than 12? Diagnosing Posterior MI and RVMI

Is 15 lead ECG better than 12 lead for diagnosing posterior MI or right ventricular infarction? When do you need a 15 lead ECG? Jesse McLaren guides us through 8 cases to highlight the steps and pitfalls in diagnosing posterior MI and RVMI in light of recent ECG literature...

ECG Cases 30 Beware Computer Interpretation Errors

Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it increases errors. This is especially problematic in the emergency department, where computer accuracy drops as clinical significance increases—with common errors for arrhythmias and ischemia. Jesse McLaren guides us through 10 cases where the computer interpretation misguides us and how to avoid these pitfalls...

ECG Cases 29 Misdiagnosis from Lead Misplacement, Artifact and Lead Reversal

In this ECG Cases blog we review 10 cases of possible artifact, lead reversal and lead misplacement. Can you spot the abnormalities and avoid the misdiagnosis?...

ECG Cases 28 Approach to Atrial Fibrillation

Jesse McLaren explains his AFIB mnemonic for approach to atrial fibrillation that involves 4 questions: 1. Is it atrial fibrillation? 2. If it is atrial fibrillation and there is rapid ventricular response, is it fast from a secondary cause? 3. If it is atrial fibrillation with a rapid ventricular response without a secondary cause, what is the intervention? 4. Does the patient need an anticoagulant started in the ED? and runs through 10 cases to elucidate the nuances of atrial fibrillation management on this ECG Cases blog...

By |2022-02-28T10:29:20-05:00February 28th, 2022|Categories: ECG Cases|Tags: , , |0 Comments
Go to Top