r/EKGs

Woman with PMx of severe kidney failure, heart failure, ablation due to AF and been electrocardioverted x3 for afib/aflutter before. Now initially felt like she had atrial fibrillation for three hours before acute onset of central chest tightness.

I honestly have no idea what kind of rhythm this is. Have clear P-waves that seem dissociated from the QRS-complexes, but there are multiple identical PR-intervals. Is this some sort of conduction block?

59 female. What do you think is happening here?

Patient had 170 troponin and 9/10 chest pain (given morphine then switched to dilaudid). This is second EKG that prompted ER physician to call the on call IC. First ekg had some st elevation and abnormalities but not as bad as this one. On call IC said ‘does not meet any criteria for STEMI’ … 🤨

I try searching for pseudo r waves in v1 for avnrt vs Frank spikes in the t wave or just outside qrs complex in v1 for avnrt in narrow complex regular rhythm tachycardias. But in this ecg for instance, i couldn't find either in the lead v1. So is it directly assumed that the p wave was too close to qrs and just fell into it?

A few months ago, my colleagues sent me an ECG of a patient who was in the internal medicine wards and was diagnosed with meningitis complicated by diabetic ketoacidosis (DKA). They asked me what I thought about the ECG.

I immediately asked whether they had the lab results, particularly the electrolyte levels, but they said they hadn’t seen them. The next day, I went to the internal medicine wards, but unfortunately, the patient had been discharged. I tried to ask the physicians, particularly about the potassium levels, and one of the residents told me that the patient had hypokalemia. I asked him if he was sure because the ECG showed peaked T waves. He responded that those T waves were normal, and he said the only abnormality on the ECG was sinus tachycardia.

I have seen several cases of hypokalemia causing peaked T waves; however, in all those cases, the QT interval was significantly prolonged, which was not the case in this ECG.

What do you think? Could this be hyperkalemia or hypokalemia?

Unfortunately, I have no more information about the patient.

Thoughts on this ECG? Attended this guy a few days ago, bit of history:

65yom, overweight, smoker. Poor diet.

3 day history of intermittent tight central chest pain, it had been worse overnight, radiating to left upper arm and jaw but didn't tell anyone til the morning and then 999 was called. Reports 2/10 pain when we were assessing him. He also had an expiratory wheeze (we were thinking undiagnosed COPD).

This is the second ECG, post paracetamol, aspirin and GTN. His first showed a little depression in limb lead ii and peaked t waves in v2,v3,v4,v5. We took to local ED. I'm no ECG expert but I had bad vibes about it, particularly with the changes in v2, v3, v4, v5 and with all his history.

Edit to add - patient hasn't attended his GP in years, takes no meds and has no known medical hx

CKD patient in the ICU, sedated. No cardiac symptoms. Wellens Syndrome? Or just LV strain?

Hello, student here... I know it's not the best photo, but is that's what my mentor sent me. I can recognize the abnormal characteristics, but I cannot give a definitive diagnosis. So I was hoping you could help me, please

Is it just artifact? Never seen anything like that before myself. Sorry for crooked.

58 YOM with history of tachycardia. Sudden onset chest tightness and diaphoresis. I can see slight STE in III and AVF, also a pathological Q in III. Possibly very slight depression in AVL.

What do yall think?

Intern here. 81M 1 month post-op inpatient was hypotensive 70/40 and running at 145ish, EKG captured this rhythm. Patient was completely asymptomatic. I had a look at prev EKG’s and the RBBB was present there too so i thought its AVRT with RBBB.

Any thoughts ?

PT biba, ambulatory w/o assistance, noted bradycardia with otherwise unremarkable vitals. Presents slightly pale, but w/o significant distress.

Hi everyone, I am a nurse specializing in elderly care. Typically, we perform an electrocardiogram (EKG) upon patient admission to assess cardiac health. Today, I observed an unusual feature specifically in lead V4 of the EKG trace. This is the first time I have encountered such a pattern. We conducted multiple EKG recordings to verify the finding, but the abnormal result persisted across all tests.