ECG cases is a monthly blog by Jesse McLaren (@ECGcases), a Toronto emergency physician with an interest in emergency cardiology quality improvement and education. Each post features a number of ECGs related to a particular theme or diagnosis (with a focus on acute coronary occlusion), so you can test your interpretation skills. We challenge you with missed or delayed diagnosis, those with false positive diagnosis, and those that had a rapid and correct diagnosis. Cases are followed by a quick summary of the literature that relates to the cases, and we bring it home with practice changing pearls that you can use on your next shift.

ECG Cases 52 – The Art of Occlusion MI, part 1: Mirror Image

In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more...

By |2024-12-03T10:26:41-05:00December 3rd, 2024|Categories: Cardiology, ECG Cases, EM Cases|Tags: , , , , , , |2 Comments
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ECG Cases 51 – ECGs falsely labeled “normal”

In this ECG Cases Dr. Jesse McLaren outlines why not to trust the ECG interpretation, even if normal, because it can miss critical findings. He explores how to independently and systematically interpret every ECG so that when the computer ECG interpretation says "normal" you don't miss key findings... Please consider donating to EM Cases to ensure it stays Free Open Access https://emergencymedicinecases.com/donation/

By |2024-10-01T12:27:53-04:00October 1st, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , , , , , |0 Comments
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ECG Cases 51 – Artifact and Lead Misplacement

ECG artifact and lead reversal can mimic tachy-arrhythmia, infarct or Brugada. Learn how to identify these errors to prevent misdiagnosis on this month's ECG Cases with Dr. Jesse McLaren... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

By |2024-09-07T12:12:52-04:00August 19th, 2024|Categories: Cardiology, ECG Cases, EM Cases|Tags: , , , , |0 Comments
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ECG Cases 50 – STEMI: A Failed Paradigm, Enter Occlusion MI

Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory ischemia, hemodynamic/electrical instability) and POCUS (new regional wall motion abnormalities).

By |2024-06-18T12:07:45-04:00June 18th, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , |0 Comments
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ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain...

By |2024-04-02T12:12:27-04:00April 2nd, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine, POCUS Cases|Tags: , , , , , , , , |0 Comments
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ECG Cases 48 – ECG Interpretation in Cardiac Arrest

In this month's ECG Cases blog Dr. Jesse McLaren reviews interpretation of the pre-arrest ECG: identifying high risk ECGs requiring empiric treatment like calcium for hyperkalemia, magnesium for long QT, or reperfusion for Occlusion MI; the intra-arrest ECG: identifying pseudo-PEA; and post-arrest ECG: the importance of serial ECGs to reduce false positive STEMI, role of POCUS to help with the differential of diffuse ST depression with reciprocal ST elevation in aVR, and identifying signs of Occlusion MI/ false negative STEMI...

By |2024-02-13T11:44:22-05:00February 13th, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , , , , |0 Comments
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ECG Cases 47 – ECG Interpretation in Toxicology

In this ECG Cases Dr. Jesse McLaren delves into ECG interpretation in toxicology and the poisoned patient using his HEARTS approach in 7 case examples. Heart rate/rhythm: consider antidotes for brady/tachy-arrhythmias, and for sinus tachycardia consider fluids for vasodilation and benzodiazepines for agitation. Electrical conduction and axis: consider sodium bicarb for QRS > 100 especially if RBBB or terminal rightward shift, and magnesium for QTc> 500. ST/T changes: consider the differential including demand ischemia, associated electrolyte abnormalities, Brugada pattern from sodium channel blockade, and acute coronary occlusion vs vasospasm from cocaine...

By |2023-12-20T16:05:22-05:00December 20th, 2023|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , , , , , , |0 Comments
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ECG Cases 46 ECG in Fever and Infectious Disease

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV strain and that fever can unmask Brugada syndrome...

By |2023-12-20T15:43:15-05:00October 17th, 2023|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , , , , , , |2 Comments
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ECG Cases 45 ECG in Weakness and Neurological Symptoms

In this ECG Cases blog Dr. Jesse MacLaren guides us through 10 cases of patients who present with generalized weakness or acute neurologic symptoms and discusses how to look for ECG signs of dysrhythmias, electrolyte emergencies, acute coronary occlusion, and demand ischemia in patients with generalized weakness and in patients with neurologic symptoms, to consider predisposing factors like LVH; seizure-like activity from cardiac syncope; TIA/CVA embolic sources like atrial fibrillation or LV thrombus; or cardiac complications like stress-induced cardiomyopathy...

By |2023-09-12T14:14:48-04:00September 12th, 2023|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , |0 Comments
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ECG Cases 44 ECG Interpretation in Epigastric pain, Vomiting

In this ECG Cases blog with Dr. Jesse McLaren we interpret 10 ECG cases and explore cardiac, metabolic and GI causes: We consider anginal equivalents, and look for ECG signs of Occlusion MI, including subacute occlusion from delayed presentations. We consider electrolyte disturbances and look for ECG signs of hyperkalemia or hypokalemia/hypomagnesemia, and we consider the differential of diffuse ST depression with reciprocal ST elevation in aVR, and false positive STEMI...

By |2023-08-08T22:28:20-04:00August 8th, 2023|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: , , , , , , , , |2 Comments
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