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 11: LBBB + Occlusion MI

In ECG Cases 11 - LBBB + Occlusion MI Jesse McLaren runs through 5 patients who present with potentially ischemic symptoms and LBBB and explains the evolution of decision making for cath lab activation criteria. The two most important points are that we should always use the Smith-modified Sgarbossa Criteria to identify occlusion MI in the patient with ischemic symptoms and LBBB, whether old or new, and that those with refractory ischemia and hemodynamic instability from suspected occlusion MI require cath lab activation regardless of the ECG....

ECG Cases 10 – Hyperkalemia: The Great Imitator

Which of the following 9 patients had hyperkalemia? Can you estimate how high their serum potassium was based on the ECG? Jesse MacLaren guides us through 9 ECGs underscoring the fact that while the ECG cannot rule out hyperkalemia, significant hyperkalemia often produces ECG changes in the heart rate (bradycardia, junctional rhythm), electrical conduction (PR prolongation or loss of P waves, QRS prolongation, pacemaker delays), and ST/T waves (Brugada phenocopy, peaked T waves that are narrow/pointy) that can be easily recognized. He suggests when you might pull the trigger on giving empiric calcium treatment based on the ECG finding in this month's ECG Cases...

By |2020-06-15T21:35:47-04:00June 15th, 2020|Categories: ECG Cases, Uncategorized|Tags: , , , , |4 Comments

ECG Cases 8 Cardiovascular Emergencies During The COVID-19 Pandemic

In this ECG Cases blog we look at 6 patients who presented with cardiorespiratory symptoms, possibly from COVID and illustrate the dangers of anchoring, being hypervigilant for cardiovascular complications, and why testing for COVID in patients being admitted for ACS is important...

By |2020-04-14T21:50:57-04:00April 14th, 2020|Categories: COVID-19, ECG Cases|Tags: , , , , |2 Comments

ECG Cases 9 – First Diagonal Occlusion

Seven patients with ischemic symptoms, none meeting STEMI criteria but all identified by a specific pattern of first diagonal branch occlusion are explored in this ECG Cases blog with Jesse MacLaren who also explains The South African Flag Sign...

ECG cases 7: ST elevation in aVR, STEMI-equivalent?

10 patients presented with the "STEMI-equivalent" ST elevation in aVR with diffuse ST depression. Which had acute coronary occlusion? Jesse McLaren guides us through the differential diagnosis of ST elevation in aVR with diffuse ST depression in this ECG Cases blog...

By |2020-03-10T16:00:59-04:00March 10th, 2020|Categories: Cardiology, ECG Cases, EM Cases, Medical Specialty|Tags: , , , |0 Comments

ECG Cases 4: Lateral STEMI or Occlusion MI?

In this ECG Cases blog we look at seven patients with potentially ischemic symptoms and subtle ECG changes in the lateral leads. Which had acute coronary occlusion?  Introducing the concept of Occlusion MI - a paradigm shift in ECG diagnosis of MI...

By |2019-12-16T17:25:04-05:00December 16th, 2019|Categories: Cardiology, ECG Cases, Emergency Medicine, Medical Specialty|Tags: , , , , , |3 Comments

ECG Cases 3: Can you find the subtle inferior MI?

In this ECG Cases blog we look at 8 patients with potentially ischemic symptoms, to highlight pearls and pitfalls of inferior MI. Can you identify which ones had acute coronary occlusion?...

ECG Cases 2: Early Repolarization or Anterior STEMI?

In this ECG Cases blog we present ECGs from 7 patients who presented with chest pain and mild anterior ST elevation. Can you identify which were early repolarization and which were anterior STEMI?