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ECG Exercise 10 - Random Assortment
ECG Exercise 10 - Random Assortment

ECG Exercise 10 - Random Assortment

Last updated 11/6/24

Imagine it’s the last 23 minutes of your single coverage shift. You have a full bladder, a pounding headache and 9 patients to dispo. You’re handed the following ECG and ask yourself: Can this patient wait for the next doctor?

ECG 1

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Triage: 50 yo with hx of CHF presents with sob and leg swelling x 2 weeks. Ran out of her meds. Normal O2sat and RR.

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What is the rhythm?
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Any abnormal findings (intervals, QRS / ST / T wave morphology)?
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Is this concerning for OMI?
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Case conclusion
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Source: ECG 1074

ECG 2

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Triage: Patient with recent pacemaker placement presents with fevers, myalgias, and pain at pacemaker site.

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What is the rhythm?
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Is the pacemaker working?
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What pacemaker complication should you be concerned about based on the question stem?
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Case conclusion
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Source: ECG 1099

ECG 3

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Triage: 42 yo M presents with cp x 3 hrs.

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What is the rhythm?
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Is this an OMI?
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Case conclusion
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Source: ECG 1077

ECG 4

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Triage: 88 yo M presents with syncope and palpitations. Forget to take his morning meds. His HR is in the 140-150s but rest of the vitals are normal.

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What is the rhythm? (What is the differential diagnosis for irregular wide complex tachycardias?)
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Case conclusion
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Source: ECG 1076

ECG 5

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Triage: 87 yo sent from clinic for asymptomatic tachycardia.

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What is the rhythm? (*look closely at the p waves)
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Case conclusion
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Source: ECG 997

ECG 6

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Triage: 53 yo F w/ history of rheumatoid arthritis cp x 3 hours.

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What’s the diagnosis here?
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Case conclusion
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Source: ECG 1084

ECG 7

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Triage: 41 yo F p/w chest pain and dizziness x 8 hours.

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Is this an OMI?
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Case conclusion
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Source: ECG 1073

ECG 8

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Triage: 94 yo M with nose pain after tripping and falling on face.

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What is the rhythm?
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What type of bundle branch block is this?
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Is this an OMI?
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Case conclusion
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Source: ECG 1086

ECG 9

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Triage: 75 yo F presents with weakness and dizziness.

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What is the rhythm?
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Does this patient need an evaluation for a pacemaker?
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More resources
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Source: ECG 1090

ECG 10

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Triage: 45 yo w/ hx of HTN (not on meds) pw chest pain radiating to L arm and back. Also drinks 10-12 cups of coffee per day

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What is the rhythm?
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Any abnormal findings?
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Is this an OMI?
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Case conclusion
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Source: ECG 1088

ECG 11

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Triage: 14 yo F with history of syncope presents with fever, cough, and sore throat.

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What diagnoses explain the abnormal findings?
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Case conclusion:
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Source: 1020

ECG 12

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Triage: 38 yo M presents with chest pain, shortness of breath, leg pain and feeling like he’s about to faint.

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What findings here are consistent with R heart strain?
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Case conclusion
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Source: ECG 1097

ECG 13

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Triage: 23 yo F 8 weeks pregnant presents with chest pain and vomiting. The ECG computer warns you to consider inferior and lateral ischemia.

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Is the computer right? or is there an alternative diagnosis?
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Case conclusion
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Source: ECG 1081

ECG 14

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Triage: 70 yo F presents with R hand pain after tripping and falling on her R hand. No prior ECGs.

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Given clinical presentation, is this an OMI?
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Case conclusion
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Source: ECG 1080

ECG 15

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Triage: Sent from clinic for admission for ankle surgery. Other than ongoing ankle pain, the patient is asymptomatic.

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What is the rhythm?
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Case conclusion
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Source: ECG 1096

ECG 16

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Triage: 26 yo M presents with chest pain and left arm tingling for x 5 hours. He drank Celsius for first time prior to the symptoms.

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Is this an OMI?
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Case conclusion
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Source: ECG 1072

ECG 17

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Triage: 43 year old M presents with syncope after a 5 sets of bench press @ 315 lbs . He now has chest pain.

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What is most concerning here?
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Case conclusion
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Source: 514

ECG 18

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Triage: History of COPD now with right sided chest pain, cough and wheezing.

Vitals: SBP 100. HR 115. O2sat 80% on RA but 100% on 4L NC.

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What qualifies as low voltage?
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What’s the next best step?
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Case conclusion
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Source: ECG 1093

ECG 19

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Triage: 36 yr old presents with weakness and dizziness.

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What’s the rhythm?, what is the differential for regular wide complex tachycardias?
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Case conclusion
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Source: ECG 1100

ECG 20

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Triage: 40 yo F w/ chest pain x 6 hrs

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Is this an OMI?
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Case conclusion
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Source: ECG 1084

ECG 21

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Triage: 50 yr old M presents with syncope and feeling cold. His oral temp is 97F in triage but otherwise has stable vitals.

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What is the rhythm?
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What’s the diagnosis that can explain the abnormal ECG findings?
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Case conclusion
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Source: ECG 1083

This post is for education and not medical advice.

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