COPY of Blog #507 — Teenager with Palpitations- EXTRA COPY

The ECG in Figure-1 — was obtained from an otherwise healthy male teenager with palpitations.

• How would you interpret this tracing?

Figure-1: The initial ECG in today's case — obtained from a teenager with palpitations. (To improve visualization — I've digitized the original ECG using PMcardio).

MY Thoughts on the ECG in Figure-1:

This is a complex tracing. I thought it best to break it down into parts.

• Beginning right after beat #6 — is a continuous run of a regular tachycardia which is wide until beat #21, when the QRS complex suddenly narrows!

NOTE: Although there is no single long lead rhythm strip — limb leads and chest leads are continuous, such that there are 30 consecutive beats on this tracing. In all — there is just under 10 seconds of monitoring.

• By the Every-other-Beat Method — the rate of the tachycardia is ~200/minute (See the ADDENDUM below for a brief ECG Video that reviews application of this concept).
• In Figure-2 — I have chosen the R wave of beat #8 in lead I as my "starting point" — because this begins precisely on a heavy grid line.
• We can see that the time it takes to record 2 beats (PINK numbers 1 and 2) — is 3 large boxes on ECG grid paper (BLUE numbers 1,2,3). This tells us that HALF of the rate = 300 ÷ 3 large boxes = 100/minute.
• Therefore, the actual rate = 100 X 2 = 200/minute.

Figure-2: Illustration of the Every-other-Beat Method for rapid estimation of fast rates. The rate of the regular tachycardia that begins after beat #6 is ~200/minute.

Today's Fast Rhythm is Supraventricular:

Although the QRS complex is wide from beat #7 through to beat #20 — the QRS then suddenly becomes narrow (ie, beginning with beat #21). This is best seen by focusing on the top row of beats in Figure-2 (ie, I suggest focusing on the 30 consecutive beats in leads I and V1 for my description below):

• PEARL #1: The facts that the last 10 beats in today's tracing clearly represent a regular SVT rhythm ( = narrow-complex tachycardia) — and that the transition from the wide tachycardia ( = beats #8-thru-20) — to the regular SVT that begins with beat #21 occurs without any pause or acceleration — suggests that this entire tachycardia is all supraventricular! (ie, If the wide beats represented VT — then it would be exceedingly unlikely for precise regularity of the rhythm to continue as the QRS narrows)!
• PEARL #2: QRS morphology during the wide tachycardia is consistent with RBBB aberrancy! (ie, The all positive QRS in lead V1 for beats #14-thru-20 — with slender initial R wave and wide terminal S wave in lead V6 for these beats — is completely consistent with RBBB conduction — as is the slender initial R wave with wide terminal S wave in lead I for beats #8-thru-13).
• PEARL #3: Putting together what we've established from PEARLS #1 and 2 — the tachycardia that begins after beat #6 is a regular SVT (albeit with a changing QRS morphology) at a rate of ~200/minute, but without sinus P waves. As I review in ECG Blog #240 — the rate of ~200/minute would be faster-than-expected for sinus tachycardia in a teenager — and unusual for AFlutter (since 2:1 AV conduction for untreated AFlutter typically results in a ventricular response close to 150/minute). Given that Atrial Tachycardia is an uncommon arrhythmia in an otherwise healthy teenager — this leaves a reentry SVT rhythm (either AVNRT or AVRT) as the most likely diagnosis for today's tachycardia, especially given the abrupt onset of this SVT rhythm.

================================ 

How Does Today's SVT Begin?

Now that we've established our "working diagnosis" as most probably being a reentry SVT rhythm — We can focus our attention on HOW this arrhythmia begins (See Figure-3):

• Beats #1,2,3 in Figure-3 — appear to be the last 3 beats in a previous SVT run at ~200/minute (that is probably of the same SVT mechanism with normal [narrow] QRS conduction as is seen in the chest leads for beats #21-thru-30).
• Beat #4 is sinus-conducted! (the 1st RED arrow in Figure-3 highlighting the sinus P wave).
• Beat #5 occurs early, and is preceded by a PAC (the 1st BLUE arrow that peaks the T wave of beat #4).
• Beat #6 is another sinus-conducted beat.
• Beat #7 is another PAC (2nd BLUE arrow in Figure-3). Note that this 2nd PAC produces a QRS complex that is wider than the normally-conducted QRS of beat #5.

Figure-3: Focusing on how the regular SVT begins.

================================ 

QUESTION:
Can you explain WHY in Figure-3 — the QRS complex of beat #7 is wider and looks different than the QRS of beats #1-thru-6?

• HINT: The measurements (in milliseconds) that I’ve added under beats #3-thru-7 in lead II of Figure-4 provide an important clue to the Answer!

ANSWER:

As I explain in the ADDENDUM below — the concept of "cycle-sequence" comparison (as it relates to aberrant conduction) — and — the Ashman Phenomenon — explain why beat #7 is wider and looks different than beats #1-thru-6 in Figure-4 (See ECG Blog #70 — for detailed illustration of the Ashman Phenomenon).

• PEARL #4: My user-friendly way to synthesize the Ashman Phenomenon is simply to recall, “The funniest-looking beat follows the longest pause”. 
• The physiologic reason for this phenomenon — is that the longer the R-R interval preceding a given beat is — the longer the RP (Refractory Period) after that beat will be (with the RP consisting of both an absolute and relative refractory period — as in ECG Blog #70).
• In Figure-4 — the R-R interval preceding beat #6 is 740 msec. — which is longer than the 720 msec. R-R interval that precedes beat #4. Therefore, by the Ashman Phenomenon — the PAC that follows beat #6 will be more likely to conduct with aberration.

PEARL #5: The other component of cycle-sequence comparison — relates to the coupling interval, which is the distance from the onset of a QRS complex until the onset of the PAC that follows it. 

• It makes sense that the shorter the coupling interval — the greater the chance that a PAC will fall within the RRP (Relative Refractory Period), and therefore be conducted with aberration.
• In Figure-4 — it is the coupling interval of the 2nd PAC that is shorter (ie, 180 msec. vs 220 msec.) — therefore explaining why beat #7 is aberrantly conducted, but beat #5 is not.
• KEY Point: There is an "art" to applying the dual concepts of "cycle-sequence" comparison — in that both a longer preceding R-R interval and a shorter coupling interval may not be present, as they are for beat #7 in Figure-4.
• PEARL #6: Given the need for preciseness when applying cycle-sequence comparison for determining the likelihood of aberrant conduction — it should be obvious that use of calipers is a must to apply this concept!

PEARL #7: The ECG Video and content in Figures-7,-8,-9 in the ADDENDUM below — review the basics of aberrant conduction. As emphasized in this review — aberrantly conducted beats most often manifest some known form of conduction block (ie, RBBB, LBBB, and/or left anterior or posterior hemiblock).

• The predominantly positive R wave in lead I — with predominant negativity of the QRS in each of the inferior leads — suggest that beat #7 in Figure-4 is conducted with LAHB (Left Anterior HemiBlock) aberration.

Figure-4: How do the measurements that I’ve added under beats #3-thru-7 in lead II explain why the QRS of beat #7 is wider and looks different than the QRS of beats #1-thru-6?

PEARL #8: It is important to appreciate that the run of reentry SVT that begins with beat #7 in Figure-4 — is initiated by a PAC! 

• In contrast to ATach (ie, an ectopic Atrial Tachycardia) that usually begins with gradual acceleration of the ectopic atrial focus ("warm-up" phenomenon) — SVT reentry rhythms often start abruptly after a PAC — because this early beat arrives at the AV Node when the faster AV Nodal pathway is still refractory.
• This may serve to set up a reentry circuit — IF as a result of the PAC, the impulse starts down the other pathway, and is then able to complete the formation of a reentry circuit (ie, IF the faster AV Nodal pathway that was blocked has recovered in time to allow return of the impulse via retrograde conduction — as shown in Figure-5). 

Figure-5: The mechanism of a reentry SVT rhythm can be seen from this schematic figure — in that each time the impulse completes its path over the reentry circuit — retrograde conduction (back to the atria) as well as forward conduction to the ventricles (through the His-Purkinje system) occurs. As discussed below (as well as in ECG Blog #240) — this retrograde conduction back to the atria can sometimes be seen on the ECG during the tachycardia in the form of retrograde P waves.
= = = = =
KEY Point: With a reentry SVT — the impulse continues to circulate over the reentry circuit until this circuit is either interrupted (ie, by AV nodal blocking drugs or a vagal maneuver or another PAC or a PVC) — or — until the reentry SVT stops spontaneously.
= = = = =
NOTE: The reentry circuit shown here in Figure-5 depicts the mechanism for AVNRT (in which the reentry circuit is completely contained within the AV Node). This differs from the situation with AVRT — in which the reentry circuit extends outside of the AV Node via participation of an AP = Accessory Pathway (See PEARL #9).

================================ 

NOTE: What follows below goes Beyond-the-Core. As an emergency provider — it is more than enough to recognize that the teenager in today's case is highly symptomatic with recurrent, rapid runs of a reentry SVT rhythm that merits referral to an EP cardiologist for EP study and probable ablation treatment.

================================ 

Beyond-the-Core:  Is there more Atrial Activity?

Take Another LOOK at Figure-4 that I've reproduced below ...

• Is there any evidence of atrial activity after beat #7?
• If so — What does this atrial activity suggest?

Figure-4: Take Another LOOK at Figure-4. Is there more atrial activity?

ANSWER:

There are a number of signs suggesting additional atrial activity that are seen after beat #7. I highlight some of these below in Figure-5:

• To Emphasize — I am not certain about all potential signs of additional atrial activity. That said — I thought this to be of less clinical importance, since this symptomatic teenager with recurrent runs of reentry SVT will need EP study regardless — to clarify the nature of his arrhythmia (and most likely for curative ablation).

================================ 

PEARL #9: Sinus P waves are upright in lead II (as well as in the other inferior leads). In contrast — retrograde P waves will be negative in the inferior leads. Other leads that commonly show retrograde atrial activity are leads aVR and V1 — in which retrograde P waves tend to be positive in these right-sided leads.

• As discussed in ECG Blog #240 — the 2 major types of reentry SVT rhythms are AVNRT (if the reentry circuit is completely contained within the AV Node) — and — AVRT (if an AP located outside of the AV Node is present and participating as the retrograde limb of the reentry circuit).
• The very sharp, negative deflections that are seen at the very end of the widened QRS complex for beats #8-thru-13 (highlighted by YELLOW arrows in Figure-6) look like retrograde P waves.
• I added yellow question marks highlighting possible retrograde P waves in the ST segment of beats #1 and 2, which are the last few beats of the narrow SVT rhythm that ends after beat #3.
• Perhaps the BLUE arrow that I added over the ST segment of beat #3 — represents another PAC that occurs with a very short coupling interval (180 msec.) but without a long preceding R-R interval, such that this PAC is blocked (therefore ending the SVT at the beginning of this tracing?).
• Perhaps the sharp, negative deflections seen in other leads during the widened SVT (ie, in lead aVF for beats #8-thru-13 — and at the very end of the QRS in leads V5,V6 for beats #14-thru-20) also represent retrograde P waves?

PEARL #10: I thought the above suggestions of retrograde atrial activity during the runs of reentry SVT in Figure-6 were occurring relatively late in the cycle — which, as illustrated in ECG Blog #240 — suggests participation of an AP (Accessory Pathway) in the reentry circuit (therefore defining the rhythm as orthodromic AVRT). 

• NOTE: The presence and participation of an AP in the reentry circuit will result in a longer reentry circuit than what occurs with AVNRT, in which the reentry circuit is completely contained within the AV Node. This is why the RP' interval tends to be longer with orthodromic AVRT compared to AVNRT (in which the reentry circuit is shorter, given that it is completely contained within the AV Node).

Figure-6: I've highlighted some indications of retrograde atrial activity.

================================ 

More about AVRT (AtrioVentricular Reciprocating Tachycardia):

A nice review of AVRT by Jabbour et al appears in StatPearls, 2024.

• A significant percentage of patients with a reentry SVT rhythm will have a "silent" AP (Accessory Pathway) that only allows retrograde conduction — which is why delta waves are never seen on a 12-lead ECG in these patients.
• Sinus P waves in these patients are preferentially conducted in the forward direction over the normal AV Nodal pathway — which is why the QRS complex is narrow.
• If a PAC occurs in such patients — it will be conducted over the normal AV Nodal pathway and, if it occurs "at just the right moment" — it may find that the AP has recovered its ability to conduct retrograde, thereby completing the formation of a reentry circuit. If the "right timing" persists (ie, with recovery of AP ability to conduct retrograde each time an impulse conducted over the normal AV Nodal pathway arrives at the His-Purkinje junction) — this may perpetuate a run of orthodromic AVRT (as appears to be happening in Figure-6).

Miscellaneous additional notes re AVRT rhythms:

• Rarely (in only ~5% of AVRT episodes) — conduction of a supraventricular impulse may arrive in the ventricles via forward conduction over the AP — with retrograde conduction to complete the reentry circuit occurring over the AV Nodal pathway (ie, antidromic AVRT). In such cases, since the forward limb of the reentry circuit passes directly to the ventricles over the AP — the QRS complex will be wide, and antidromic AVRT may look identical to VT.
• On occasion — a patient may have more than a single AP (with this consideration relevant to the conclusion of today's case — as I discuss below).
• The ability of an AP to conduct retrograde (and participate in the reentry circuit of an AVRT rhythm) is not necessarily lifelong. Especially in children — the ability of a "silent" AP to conduct retrograde often resolves as the child becomes older.
• The abrupt switch of a reentry SVT that begins with QRS widening (ie, with either RBBB or LBBB conduction) — but then suddenly normalizes QRS duration without appreciable change in the R-R interval between wide vs narrow beats — suggests that an AP may be participating in the reentry cycle (This is seen beginning with beat #21 in Figure-6). 
• 
  
• Coumel's law may then help to predict localization of the AP:
• IF the R-R interval is slightly longer during the SVT with RBBB conduction than when the QRS is narrow — then the AP is right-sided. 
• IF the R-R interval is slightly longer during the SVT with LBBB conduction than when the QRS is narrow — then the AP is left-sided.

================================ 

CASE Follow-Up:

EP study was done on today's patient — and verified the presence of a participating AP in the reentry circuit (thereby confirming orthodromic AVRT as the mechanism of the arrhythmia).

• Noted in the EP report was that atrial stimulation induced orthodromic AVRT mediated by a concealed left lateral AP.
• Intermittent tachycardia was seen with RBBB conduction while maintaining the same cycle length — and with LBBB conduction manifesting a longer cycle length. This confirmed left-sided localization of the AP ( = Coumel's sign).
• The pathway was ablated — after which it was no longer inducible on EP study.

Unfortunately — Holter monitoring following ablation showed some recurrence of the SVT rhythm.

• I do not have further follow-up at this time.
• As I noted earlier — it is known that on occasion more than a single AP may be present. I suspect this may be the case with today's patient — as alternating participation by more than a single AP would seem the most logical explanation for recurrence of this patient's reentry SVT rhythm after ablation of only one of the APs.
• I suspect a 2nd EP study may be needed to identify one or more additional APs that may need to be ablated.

==================================

Acknowledgment: My appreciation to Amelia Aria (from Bucharest, Romania) for the case and this tracing.

==================================

================================ 

Related ECG Blog Posts to Today’s Case: 

• ECG Blog #185 — Reviews the Ps, Qs & 3Rs Approach to systematic rhythm interpretation.
• ECG Blog #240 — and ECG Blog #345 — Atrial activity in reentry SVT Rhythms.

=======================================

ADDENDUM #1 (11/XXXX/2025): Included below is the following:

• The Every-other-Beat Method for rapid estimation of fast rates.
• More on aberrant conduction.

ECG Media Pearl #27 (3:00 minutes Video) — ECG Blog #210 — Reviews the Rule of 300 for estimating heart rate — and — @ 1:25 minutes in the video, the Every-Other-Beat Method for Estimating Rate with fast rhythms (4/2/2021).

================================ 

ECG Media PEARL #28 (4:45 minutes Video) — Reviews WHY some early beats and some SVT rhythms are conducted with Aberration (and why the most common form of aberrant conduction manifests RBBB morphology).

• NOTE: I have excerpted a 6-page written summary regarding Aberrant Conduction from my ACLS-2013-ePub. This appears below in Figures-7, -8, and -9).
• CLICK HERE — to download a PDF of this 6-page file on Aberrant Conduction. 

Figure-7: Aberrant Conduction — Refractory periods/Coupling intervals (from my ACLS-2013-ePub).

 

Figure-8: Aberrant Conduction (Continued) — QRS morphology/Rabbit Ears.

 

Figure-9: Aberrant Conduction (Continued) — Example/Summary.

EXTRA COPY- Dr. Smith ECG Blog- LINKS to My Comments (11-7.1-2025)

 

NOTE: Since end-May, 2018 — I have regularly written a "My Comment" feature on Dr. Smith's ECG Blog (with limited comments during 2021). 

• Prior to May 24, 2018 — I frequently added comments as an avid reader to Dr. Smith's posts. CLICK HERE — for a link to those comments before 5/24/2018.
• I contributed to 310 posts up until I stopped in Dec., 2020. 
• From June, 2021 — through 6/17/2025 — I contributed to ~450 more posts ...
• From June 25, 2025 — thru 11/6/2025 when WordPress began:
•                                                     — I have now contributed ~503 more posts —
•    

===================================== 

For My Comments on Dr. Steve Smith's Blog (as Associate Editor):

• Cardiac Arrest/Abnl ECG (RVH/LVH-Katz-Wachtel) May 24, 2018 -
• Acute Posterior MI despite RBBB (posterior leads Not) May 26, 2018 -
• LIST: A Long QT/QU + U Waves (Drugs/Lytes/CNS)- May 27, 2018 -
• Paced ECG + Primary ST-T Changes! (Acute MI) May 29, 2018 - 
• Repost of 2015 WCT Rhythm: Is the QRS Wide??? May 30, 2018 -
• LBBB with LA-LL Lead Reversal + Suble ST Changes June 4, 2018 -
• Brady, Wide QRS, Pointed T, Hypotension (artifact) - June 6, 2018 - 
• Is the QRS really so Wide? (shark fin) - June 11, 2018 - 
• Inf. STEMI vs Constrict Pericarditis (Schamroth sign) June 17, 2018 -
• WPW or AIVR? Why AIVR? ( = Sinus Brady ...) - June 18, 2018 -
• What is Terminal QRS Distortion (Pericarditis @ Peril) June 20, 2018 -
• LBBB, modify Sgarbossa, Qualitative ST-T Changes June 22, 2018 -
• Does ECG help Manage Insulin Overdose? (low K+) June 24, 2018 -
• Early Repol vs OMI vs Pericard (AFib/Group Beating) June 26, 2018 -
• Wellens' Syndrome + Change in Serial Tracings! - June 28, 2018 -
• Type 1 MI with a Normal Cath (isolated high lateral MI) - July 1, 2018 - 
• Use of Terminal QRS Distortion to make Diagnosis! - July 3, 2018 -
• Slow AFib + Syncope (about Sick Sinus Syndrome!) - July 5, 2018 -
• 
  
• When Should the OMI Dx have Been Made? - July 8, 2018 -
• Inf. OMI + RV MI (Hyperacute ST-T / Mirror-Image) - July 11, 2018 -
•    — Also — ischemia-induced J-waves (My July 11 Comment)
• 
  
• Acute High Lat. OMI (only seen in aVL) - July 13, 2018 -
• Recognizing LQTS (Long QT Syndrome) on ECG - July 17, 2018 -
• Sodium-Channel Blockade on ECG (Long QTc) - July 20, 2018 -
• Findings of Hypokalemia - and — Anything Else? - July 22, 2018 -
• Findings of Hyperkalemia (Eiffel Tower/Rhabdo) - July 24, 2018 -
• ST Elevation? (Acute PE/Simultaneous Leads) - July 26, 2018 -
• Paramedic recognize subtle OMI (V1,2 malposition) - July 28, 2018 - 
• Limb Lead and Chest Lead Misplaced (Recognize!) - July 29, 2018 -
• CP in 30yo f (Subtle Abns in 11/12 leads/Compare) - July 31, 2018 -
• A Regular SVT — How to Diagnose AFlutter? - August 3, 2018 -
• A Regular WCT with an LBBB-like Pattern ... - August 5, 2018 -
• A 13yo with SOB (WPW - arrhythmias - localization) - August 7, 2018 -
• Lots of ST Elev.: Repol vs STEMI? (mirror-image) - August 9, 2018 -
• Acute LMain Occlusion! — a subtle initial tracing - August 30, 2018 -
• 2 Occlusions (Less good ECG interpretation ... ) - Sept. 2, 2018 -
• Reverse Takotsubo and an Unusual ECG - Sept. 4, 2018 -
• Subtle Post-Lat OMI (LCx) + VT with AV Diss/Capture - Sept. 7, 2018 -
• 50yo Woman with CP & "Normal" Triage Tracings - Sept. 11, 2018 -
• Acute PE (ECG & Echo findings) - Sept. 12, 2018 -
• Idiopathic VT — Fascicular VT (See My Comment) - Sept. 14, 2018 -
• Subtle Serial ECG Changes in a 30yo with CP - Sept. 15, 2018 -
• Hyperacute T Waves (The Wrong Question was Asked) - Sept. 20, 2018 - 
• AFlutter with subtle Anterior STEMI (Use calipers! ) - Sept. 24, 2018 -
• Cabrera Format - 50mm/second speed - Chest Pain ... - Sept. 26, 2018 -
• Dialysis Patient — "Pseudonormalization" ST-T Waves - Sept. 29, 2018 - 
• Giant T Waves / Origin of an Atrial Rhythm - October 1, 2018 - 
• Paced ECG with Acute Anterior STEMI (Sgarbossa) - October 3, 2018 - 
• Subtle Acute High-Lat STEMI (aVL-mirror image) - October 6, 2018 - 
• Acute STEMI diagnosed ONLY by PVC Morphology - October 8, 2018 - 
• Another Invalid Study on Triage ECGs in the ED - October 9, 2018 - 
• Subtle OMI in a Triage ECG (PR vs TP Baseline) - October 14, 2018 - 
• Anterior MI + PVCs (Subtle rhythm-junctional escape) - Oct. 19, 2018 - 
• 80yo man with sudden PEA (no clear "culprit" on ECG) - Oct. 22, 2018 -
• Normal Troponin & Acute Occlusion (ischemic J waves) - Oct. 24, 2018 - 
• Inf. ST Elev but No MI! (ST straightened- a "normal" ST) - Oct. 27, 2018 - 
• Diffuse ST Dep/ST Elev in aVR (Recognize this pattern! ) - Oct. 31, 2018 - 
• Q waves in V1,V2 = Septal MI? (or V1/V2 Misplacement?) - Nov. 4, 2018 - 
• Recognition of a Long QTc (Assessing the QTc- LIST ) - Nov. 7, 2018 - 
• A Case-Based Study of Pacer Malfunction (bradycardia) - Nov. 9, 2018 - 
• 2 ECGs Texted to Dr. Meyers (Acute STEMI or not?) - Nov. 12, 2018 - 
• Serial ECG Changes over 10 tracings in Acute STEMI - Nov. 15, 2018 - 
• Hyperacute T waves - new LAHB + Inf. Q waves = OMI - Nov. 18, 2018 -
• RBBB + Chest Pain: New vs Old? - Nov. 21, 2018 - 
• Acute STEMI missed by the Computer - Nov. 21, 2018 -
• Are these Hyperacute T waves? (Computer says stemi) - Nov. 24, 2018 - 
• Regular SVT at 200/min. + acute STEMI? (Semantics) - Nov. 26, 2018 - 
• ST Elev. in V1,V2 — STEMI? Brugada-2? (or leads?) - Nov. 28, 2018 - 
• Shock, LVH and/or Diffuse Subendocardial Ischemia - Nov. 30, 2018 -
• 2 ECGs without a History: Acute Changes or Not? - Dec. 5, 2018 - 
• Not Bigeminy — But a Problem with K+ & Ca++ (DKA) - Dec. 11, 2018 - 
• Can this be Wellens' Syndrome without an Infarct? - Dec. 14, 2018 -
• A Regular WCT: VT vs AFlutter + Flecainide Toxicity? - Dec. 16, 2018 - 
• The Computer Called this Normal (Subtle STEMI ) - Dec. 19, 2018 - 
• Subtle ST-T wave changes (Normal vs Flat ST segment) - Dec. 24, 2018 - 
• ST Elevation in V1-3: Ant MI vs "Strain" (ECG Dx of LVH)- Dec 27, 2018 - 
• ST Elevation in V3: Is it Normal? (More on ECG Dx LVH) - Dec. 29, 2018 - 
• Benign T Wave? Hypertrophic CardioMyopathy? - Jan. 2, 2019 -  
• "Who Done It? = HyperKalemia + HypoCalcemia - Jan. 3, 2019 - Jan 7 -
• Dynamic ST-T Wave Changes (Myocarditis, LVH) - Jan. 9, 2019 -
• Isolated RV MI + unusual pointed ischemic T waves - Jan. 11, 2019 -
• Bradycardia & AV Block from Hyper-K (Rhythm Pearls) - Jan. 13, 2019 - 
• The Regular WCT: VT vs SVT with Aberrancy? - Jan 24, 2019 - 
• Junctional vs Low Atrial Rhythm? (neg P  or part QRS?) - Jan. 28, 2019 - 
• Hyperthermia and ST Elevation in V1,V2 (Brugada-1) - Jan. 30, 2019 - 
• Diffuse ST Dep/ST Elev in aVR not due to CAD (low K+) - Feb. 2, 2019 - 
• Subtle OMI diagnosis by ECG Comparison (pos Trop) - Feb. 5, 2019 - 
• Right-Sided HF and an SVT (Why is this AFlutter?) - Feb. 9, 2019 -
• RVH - IRBBB: Is Ant T Inversion New or Old? - Feb. 12, 2019 - 
• How Long Will You Wait for OMI to become STEMI? - Feb. 16, 2019 - 
• Coved ST Elevation in Chest Leads: Acute or Not? - Feb. 18, 2019 - 
• Cardiac Arrest, ROSC and now RBBB? (very wide! ) - Feb. 28, 2019 - 
• LVH, diffuse ST dep/ST elev in aVR (Sickle Cell ) - March 2, 2019 - 
• Monitor Leads for ST Elevation? (Filter Settings! ) - March 4, 2019 -
• Recognizing abnormal ST elevation in V1,V2 - March 6, 2019 - 
• Subtle Acute MI (Is complex A or B in aVL correct?) - March 8, 2019 - 
• Resp. Failure + a "Normal" Computer ECG ("smiley" ) - March 11, 2019 - 
• What is the Rhythm? (2 Regular WCTs vs 1 Rhythm?) - March 13, 2019 - 
• The SHAPE in lead V2 — Acute OMI - March 15, 2019 - 
• Acute OMI Dx'd by Speckle Echo (an unusual IVCD) - March 18, 2019 - 
• Electrolytes — Pathognomonic ECG (hypoCa/hyperK) - March 19, 2019 - 
• Junctional Escape (Laddergram)/SubEndo Ischemia - March 26, 2019 -
• Subtle High-Lat OMI + 3 False Pos (ST elev in aVL) - March 29, 2019 -  
• 3 ECG shown to Dr. Meyers (To Activate Cath Lab? ) - March 31, 2019 - 
• Acute LAD Occlusion in an Elderly Patient - April 3, 2019 - 
• ECG Findings & Clinical Diagnosis of Acute PE - April 5, 2019 - 
• A Pt with Abdominal Pain and LBBB (qualitatively + ) - April 7, 2019 -
• Acute OMI missed because it wasn't a "STEMI" - April 12, 2019 - 
• Type 2 MI + Myocardial Bridging + Tachy/ST Elev - April 15, 2019 - 
• Acute Pericarditis or a Repolarization Variant ECG? - April 19, 2019 -
• OMI despite no STEMI ( + V2 lead malposition) - April 20, 2019 - 
• CP & ST Depression only in leads I and aVL ... - April 22, 2019 -
• A WCT Rhythm with Alternating Wide-Narrow Beats - April 23, 2019 - 
• Dx of Acute STEMI despite being a Paced Tracing - April 25, 2019 - 
• Terminal QRS Distortion (T-QRS-D) - LVH Voltage - April 27, 2019 - 
• LBBB vs WPW (LBBB criteria- All about WPW) - April 30, 2019 - 
• Tachyarrhythmias: Use of Monitor vs a 12-Lead ECG - May 1, 2019 - 
• De Winter T Waves (Typical & Atypical Features) - May 2, 2019 - 
• Brugada ECG Patterns vs Acute Anterior STEMI - May 6, 2019 - 
• Don't Overlook this OMI (Be Systematic/Computer Use) - May 7, 2019 - 
• Another Anterior OMI/Not Repol (the Visual Picture) - May 11, 2019 - 
• Chest Pain in a Pt with a Paced Rhythm (2:1 ATach?) - May 13, 2019 - 
• Peaked T Waves despite serum K+ = 2.4 mEq/L - May 15, 2019 -
• LVH and/or Acute OMI (Nit-Picking Serial Tracings/LVH) - May 19, 2019 - 
• LBBB: Recognizing Acute OMI (Smith-Mod-Sgarbossa) - May 24, 2019 - 
• Acute Ant. OMI (What will the Cardiologist do Next Time?) May 26, 2019 - 
• A Complex ECG and No Clinical Info (Laddergram) - May 28, 2019 - 
• Superimposed Changes on Prior Antero-Lat STEMI? - June 2, 2019 - 
• Cardiologist & Computer said "Normal" (acute OMI) - June 4, 2019 -  
• Is ST-T wave SHAPE normal? (Cath lab activation? ) - June 7, 2019 -
• How Not to Miss WPW (Reviews My Approach) - June 8, 2019 - 
• Hyperacute T Waves (on way down) - Computer - June 9, 2019 - 
• 20yo with Chest Pain: Early Repol or Something Else?- June 11, 2019 - 
• A Patient with SOB (Systematic-LVH-QTc-hyper-K+) - June 15, 2019 - 
• Dr. Smith's 3- and 4-Variable Formula (Ant STEMI? ) - June 17, 2019 - 
• Repolarization Variants vs LVH-HCM-STEMI? (blacks) - June 20, 2019 - 
• "Smiley"-shape ST Elevation (Using this Concept! ) - June 22, 2019 - 
• Very Subtle Inferior Lead ST-T Wave Change - June 23, 2019 -
• Quick Recognition of Acute Proximal LAD Occlusion - June 26, 2019 -
• A System needed to pick up all Findings! (Inf OMI ) - June 28, 2019 - 
• 2 Cases of RBBB (My Approach for ECG Dx of BBB) - July 1, 2019 - 
• CP Onset 24-48 Hrs Ago (2 Post MIs- Correlate to Hx) - July 5, 2019 - 
• Subtle-but-definite acute LAD OMI (artifact! ) - July 11, 2019 - 
• ST Elevation only in V6/Recip in V1 (LCx-Post MI ) - July 15, 2019 - 
• Doubling Size of Complexes Facilitates OMI Dx! - July 17, 2019 - 
• Subtle LAD OMI: New vs Old? (Brugada-like) - July 19, 2019 - 
• Acute MYOCARDITIS vs OMI vs Repol (Serial Tracings) - July 21, 2019 - 
• The ECG was Correct; Cath was Not! (Late-Cycle PVCs)- Aug. 13, 2019 - 
• 5 Cardiologists say No STEMI — Is in an OMI? - August 15, 2019 - 
• CP in a 50yo with a "Normal" ECG — Or an OMI? - August 18, 2019 - 
• Evidence of Acute OMI on this Pacer Tracing? - August 20, 2019 - 
• Are these Hyperacute T Waves? - August 26, 2019 - 
• Short QTc Syndrome vs Hyperkalemic T Waves - Sept. 2, 2019 - 
• Recognize this ECG? (HyperK- Brugada Phenocopy) - Sept. 8, 2019 - 
• Non-Cardiac Ischemia on ECG (+ a few questions) - Sept. 12, 2019 - 
• Troponin Trajectory: New Ant MI vs LV Aneurysm? - Sept. 17, 2019 - 
• When the QRS is Wide — the J-Point will Hide! (VSD) - Sept. 20, 2019 - 
• Why do beats "A" and "B" look so different? (artifact) - Sept. 22, 2019 - 
• 7 mm of ST Elevation with LBBB = Acute? What Else? - Sept. 25, 2019 - 
• Acute MI diagnosis by Chest CT (+ suble ECG/Artifact) - Sept. 27, 2019 - 
• Subtle Inf. OMI / MAT at normal Rate - Sept. 30, 2019 - 
• ST Depression in a 30yo (Atrial Repol Wave/Tachycardia) - Oct. 2, 2019 - 
• Shark Fin Morphology (Don't Forget to look for P waves! ) - Oct. 4, 2019 - 
• Interplay between Post MI and acute RV MI! - Oct. 9, 2019 - 
• Do You Understand these T Wave Inversions? - Oct. 10, 2019 - 
• Regular SVT (AVRT — 30yo with WPW — Mgmt) - Oct. 16, 2019 - 
• Acute Inf-Lat OMI (QS inf leads-Tall R V1-Silent MI ) - Oct. 20, 2019 - 
• Causes of ST Depression ("scooped" ST/Dig/LIST ) - Oct. 21, 2019 - 
• SCAD (Spontaneous Coronary Artery Dissection) - 30f - Oct. 24, 2019 - 
• Look at All ECGs done Serially! (Subtle clues! ) - Nov. 1, 2019 - 
• Diffuse Subendocardial Ischemia (not always cardiac! ) - Nov. 3, 2019 - 
• Vagotonic AFib in 30yo (The RATE of AFib - D.D.) - Nov 5, 2019 - 
• Subtle Changes = an ECG non-diagnostic of OMI (Lytics?) - Nov. 8, 2019 - 
• What is this SVT @ 150/min? (AFlutter — MY POST ) - Nov. 12, 2019 -
• Repolarization Variants vs Acute OMI (T-QRS-D) - Nov. 14, 2019 - 
• Seizures — Review of HypoKalemia - Nov. 18, 2019 - 
• CP in a 30yo — Acute OMI? (Serial ECGs) - Nov. 20, 2019 -
• Cardiac Arrest — Shark Fin/ Osborn Waves/ Low Atrial - Nov. 22, 2019 -  
• Is there Global ST Depression? — or Atrial Flutter? - Nov. 26, 2019 - 
• Acute Pancreatitis/LVH and Repol vs Acute OMI? - Nov. 27, 2019 - 
• Distinguishing New vs Old MI (vs superimposed MI) - Nov. 29, 2019 - 
• A 30yo woman with Fever-Induced Brugada-1? - Dec. 5, 2019 - 
• CO Poisoning — Prox LAD Occlusion (T-QRS-D ) - Dec. 9, 2019 - 
• Acute Myocarditis vs Repol vs OMI (Serial ECGs) - Dec. 10, 2019 - 
• Acute PERICARDITIS (detailed discussion! ) - Dec. 13, 2019 - 
• Acute OMI despite LBBB (Smith-Sgarbossa- subtle! ) - Dec. 16, 2019 - 
• More on HypoKalemia - Dec. 18, 2019 - 
• A Regular WCT (Wide-Complex Tachycardia) - Dec. 23, 2019 - 
• Don't Overlook AFlutter! (Regular SVT at ~150/minute) - Dec. 24, 2019 - 
• Mobitz II in an Asymptomatic 80yo (AV Blocks) - January 1, 2020 -  
• Hypothermia with Osborn Waves! - Jan. 2, 2020 - 
• MAT - the Computer - Aberrant Conduction (Ashman) - Jan. 5, 2020 - 
• Crochetage Sign — Is there an ASD? - Jan. 8, 2020 - 
• Acute Pericarditis (Myocarditis)? Acute OMI? Repol? - Jan. 10, 2020 - 
• Acute MI + Post-Infarction Pericarditis (Review) - Jan. 14, 2020 - 
• Acute LMain Occlusion (ECG Recognition) - Jan. 16, 2020 - 
• Acute Inf OMI (Complex Rhythms-Ladder-Mobitz I ) - Jan 19, 2020 - 
• RBBB + 1° ST-T changes/AFib + AV Block (SSS? ) - Jan 22, 2020 - 
• "Shark Fin" / Myocardial "Stunning" ==> Low Voltage - Jan. 24, 2020 - 
• Hyperkalemia (Ventricular Escape - ECG Changes) - Jan. 26, 2020 - 
• 20-ish yo with Chest Pain (distal LAD OMI - subtle) - Jan. 29, 2020 - 
• Hx of Stents with Chest Pain (RBBB-Fragmentation) - Jan. 31, 2020 - 
• 7 Tracings: Which 3 have Acute Inferior OMI? - Feb. 2, 2020 - 
• Cardiology would Not Cath this Patient! (Ant. OMI ) - Feb 4, 2020 -
• ST Elevation in V1,V2 — due to LVH (not ACS) - Feb. 6, 2020 -  
• Ischemia vs Lead Misplacement (How to Recognize) - Feb. 11, 2020 - 
• A 50s Man with "Gas Pain" (Early LAD Occlusion) - Feb. 14, 2020 -
• HypoThermia — Shark Fin (Causes of Myocarditis) - Feb. 16, 2020 -
• 32yo with CP — Hyperacute T waves MISSED - Feb. 18, 2020 - 
• What are these Wide Complexes (AV Diss- AIVR) - Feb. 20, 2020 -  
• Anterior T Inversion (Not Wellens- PE vs Ischemia) - Feb. 28, 2020 -
• A Man in his 60s with CP (Subtle OMI) - March 2, 2020 - 
• Sinus Tach with a VERY Long PR Interval - March 4, 2020 - 
• ATach vs AVNRT of the Fast-Slow Type - March 6, 2020 - 
• ST Elevation in aVR (Coronary Occlusion?/SVT? ) - March 9, 2020 -
• A Scenario to Recognize (Irregular WCT-AFib/WPW) - March 12, 2020 - 
• 32yo with CP (LA-RA Lead Reversal + acute OMI) - March 18, 2020 - 
• 50ish yo with ETOH Ketoacidosis (Takotsubo CMP) - March 25, 2020 - 
• 30yo with CP (Tom Fiero case- acute OMI missed) - March 29, 2020 -   
• PVCs and AV Block? (NOT! - Interpolated- My Case) - April 9, 2020 -   
• Man in 60s (RBBB Basics-Hemiblocks-Acute OMI) - April 13, 2020 -  
• Differential Diagnosis of a Regular WCT (VT/LPHB) - April 15, 2020 -  
• Acute OMI not seen on ECG (subtle V1 ST elev) - April 20, 2020 - 
• Why 3 QRS Morphologies? (Rate-Related BBB) - April 22, 2020 -  
• Is it VT or SVT with Aberrancy? (MY Case! ) - May 5, 2020 - 
• Ant. ST Dep: Post MI or Subendocardial Ischemia? - April 24, 2020 -  
• "Shark Fin" with Twist (pseudo-MI- Hyper-K+ ) - April 25, 2020 - 
• Cardiac Arrest- Torsades vs PMVT (bizarre PVCs) - April 29, 2020 - 
• A 20yo with Vomiting (low K+ - Causes of Long QT) - May 3, 2020 - 
• ECG from a Study (Normal variant - Gestalt! ) - May 7, 2020 -
• The Many Faces of HypoKalemia! (Table-K+ ) - May 9, 2020 - 
• 50yo/SOB/Covid-19 (Indeterminate Axis-MyoCard) - May 11, 2020 -  
• Diffuse Subendocardial Ischemia (Normal Echo! ) - May 13, 2020 -
• Cardiac Arrest/ECMO — Shark Fin (rhythm-Type II MI) - May 19, 2020 - 
• AV Block & Something Else? (Ladder! - MY Case) - May 16, 2020 - 
• Subtle AFlutter (looks like sinus tach-MY Case) - May 22, 2020 -
• Syncope- Long 1st Deg. (AV Diss vs 3rd- P or U-wave?) - May 24, 2020 - 
• Early Repol vs Acute OMI (GOOD- R/O acute OMI ) - May 26, 2020 - 
• A Different Kind of WCT (Pleomorphic VT ) - June 1, 2020 -  
• SVT at 160 — then 240/minute (AVNRT-Adenosine) - May 31, 2020 -  
• What is the Culprit Artery? (prox LAD vs RCA/RV MI ) - June 6, 2020 - 
• Emery Phenomenon = (Pseudo-MI from neg P in lead II ) - June 3, 2020 - 
• A Fast Regular WCT/BBB-Reentry VT (at ~268/minute! ) - June 9, 2020 - 
• A 50-something man (SUBTLE MI !!! ) - June 12, 2020 -  
• Drug O/D with Fascinating Arrhythmia (Ladder! ) - June 13, 2020 - 
• Man in 60s — ROSC, Hyperacute T Waves (lad omi) - June 15, 2020 - 
• LVH causing ST Elevation in V1,V2 (not a STEMI!- LVH) - June 20, 2020 - 
• GIANT T Waves (Table) - HypoKalemia - June 22, 2020 -  
• Intermittent Wide QRS - No Hx (RBBB-MY Case) - June 25, 2020 - 
• Severe HyperNatremia (also hyper/hypo-Ca++ ) - July 1, 2020 - 
• A 60-something man (AFib/Ashman phenomenon) - June 17, 2020 - 
• Resuscitation ECGs are Often Bizarre (Spiked Helmet) - June 28, 2020 -  
• Trauma & blood Transfusions (hypo-Ca++/hyper-K+ ) - July 3, 2020 - 
• An Elderly Man with Hiatal Hernia (ischemic ST-T/new AFib) - July 7, 2020 - 
• Subacute MI (MI of ? Age/Dating MI - ongoing CP-for Cath) - July 9, 2020 -
• 20yo with Syncope (Pericarditis - Pericardial Tamponade) - July 12, 2020 -  
• CP — RBBB — Subendocardial Ischemia (No Cath Lab!) - July 15, 2020 -  
• Subtle Inferior/RV MI (Acute RV MI- Right-sided leads) - July 19, 2020 - 
• Interesting Troponins (Dynamic ST-T Wave Changes) - July 21, 2020 -  
• New Dyspnea (RA-LL Lead Reversal- USE! ) - July 28, 2020 - 
• 50yo man — de Winter-like OMI (late-cycle PVCs) - July 26, 2020 -  
• The OMI Manifesto (Summary) - July 31, 2020 - 
• Subtle OMI from France (Computer) - August 1, 2020 - 
• 40yo man — another OMI (STEMI-neg- Greece) - August 4, 2020 -  
• Middle-aged woman (OMI not Pericard- Q wave size) - August 8, 2020 - 
• VERDICT Trial (Use of CT Angiography for NSTE-ACS) - August 8, 2020 -  
• 4 Tachyarrhythmias in a Man with CP - August 13, 2020 -
• 35yo (MY Case - Ladder! - Mobitz I-Phase 4- RHYTHM) - August 17, 2020 -  
• Pseudo-Wellens' Syndrome (Why it is not Wellens! ) - August 19, 2020 - 
• Dynamic ST-T Change (Repolarization Variant) - August 21, 2020 -  
• Acute OMI + RBBB/LAHB (Cardiology oversight! ) - August 24, 2020 -
• Low Voltage, Cardiogenic Shock & Subtle OMI - August 28, 2020 - 
• 31yo with HTN + ST Elev/T Inversion (but not OMI) - August 30, 2020 -
• 21yof with SOB,exertional syncope (ECG Dx of RVH!) - Sept. 1, 2020 - 
• The OMI Manifesto (17 minutes — Dr. Meyers) - Sept. 3, 2020 -
• HyperKalemia (serial ECGs - Brugada Phenocopy) - Sept. 5, 2020 -
• SVT at 257/minute (Idiopathic VT- Fascicular/RVOT VT) - Sept. 7, 2020 -
• AV Wenckebach (Dual AV Pathways- Laddergram) - Sept. 9, 2020 - 
• An 18yo with CP (ST/T Ratio - Pericarditis vs Repol) - Sept. 11, 2020 -
• Acute Inf-Post-Lat OMI (Mirror- Fig of OMI Findings) - Sept. 13, 2020 - 
• 58yo with False Positive OMI (Repolarization Variant) - Sept. 15, 2020 -
• 60yo with LBBB + Acute OMI (MY Case) - Sept. 17, 2020 -
• Cardiac Arrest with Neg initial Troponin - Sept. 19, 2020 -
• Cardiologists limited by STEMI Criteria (Mirror- Post MI) - Sept 21, 2020 - 
• Prominent J (Osborn) Waves as Sign of Acute OMI - Sept. 23, 2020 -
• Cardiac Arrest/Massive PE (Not Complete AV Block) - Sept. 24, 2020 -
• 40-yo with Irreg. Rhythm (MY Case- Runs of PACs-Ladder) - Sept. 26, 2020 -
• Another Post MI missed by Cards (Mirror- Hyper-K+) - Sept. 28, 2020 - 
• Missed OMI (Subtle Posterior MI- LCx OMI ) - October 2, 2020 -
• Partially Paced ECG with Inf-Post-Lat OMI - October 5, 2020 -
• Is this Wellens' Syndrome (LVH - AV Diss- Ladder) - October 9, 2020 -   
• The Posterior Paradox (Post MI- Mirror- Silent MI) - October 11, 2020 -
• Serial ECGs = a STEMI that Resolves (11/12 leads) - October 14, 2020 -
• Covid with a Regular WCT ( Not VT but ARTIFACT) - October 17, 2020 -   
• Brooks: PACER ECG that is Acute OMI (My Comment) - October 19, 2020 - 
• HyperKalemia — Advanced Points (My Comment !!! ) - October 21, 2020 - 
• 40-yo with CP (Repol vs LVH vs Subtle Ant. OMI !!!) - October 23, 2020 -
• Shark Tooth "Silent Ischemia" + VT (Cabrera Format) - October 26, 2020 -
•    — MY Review on Cabrera format — GOOD on Coronary Spasm —
• 
  
• Septal OMI? (Saddleback- Many ECG Findings) - October 28, 2020 -
• 60-yo with Weakness (My Comment- HyperCalcemia) - October 30, 2020 - 
• An ECG without History is Mystery (Wellens! ) - November 6, 2020 -  
• This can be Taught: Qualitative Approach to ECGs (OMI) - Nov. 8, 2020 -  
• A 30-something Man - CP - Artifact-D.Richley-Christopher- Nov. 10, 2020 -  
• Extreme SHOCK + COVID (Low Voltage - RA artifact) - Nov. 12, 2020 -
• ATach with Block - Dig Toxicity (My Comment- Ladder) - Nov. 24, 2020 -
• Amyloid with Slow AFlutter vs ATach & 2:1 Block - Nov. 15, 2020 - 
• Anterior ST Elevation (LVH) + LA-LL Lead Reversal - Nov. 19, 2020 -
• VFib/ subtle OMI-TABLE! (Inter-Intra Observ Variability) - Nov. 17, 2020 - 
• Resident not Faculty saw OMI (Lead aVL- Coronary Circ.) - Nov. 21, 2020 -
• 49yo-Serial ECGs-Wellens Syndrome (My LAST Comment) - Dec. 4, 2020 -

 

I Resumed MY Commentary after June, 2021:

• Acute prox. RCA Occlusion (2nd-Degree- LADDERGRAM) - Jun. 17, 2021 -
• A Child with Biphasic T Waves in Leads V1,V2 - July 10, 20201 -
• AV Block? Echo beats?  — No, Interpolated PVCs - July 16, 2021 -
• AV Block that "doesn't obey the rules" (Hyperkalemia) - October 16, 2021 -
• PEA Arrest & AV Blocks (subtle 2:1; dual-level Wencke) - October 27, 2021 -
• WCT Case: 1 VT site, but Changing QRS Morphology! - Nov. 6, 2021 -
• LA-RA Lead Reversal misdiagnosed as acute OMI - Nov. 27, 2021 -
• Large Ta Wave simulates Ischemic ST Depression - Dec. 9, 2021 -
• Detection of Posterior OMI (Use of Mirror Test! ) - January 3, 2022 -
• Giant T-Wave Syndrome (LVH-Apical HCM) - January 8, 2022 -
• Marked ST Abnormality = CNS/OMI/Takotsubo? - January 14, 2022 -
• Other ECG Findings of Life-Threatening Hyper-K+ - January 16, 2022 -
• Subtle ECG Signs of acute OMI in LBBB — January 31, 2022 -
• This ECG Interpreted by Computer as Normal (OMI) — Feb. 4, 2022 -
• Hypothermia to 18°C (with huge Osborn Waves) — Feb. 8, 2022 -
• Jessie McLaren: 6 serial ECGs (subtle OMI- Mirror! ) — Feb. 10, 2022 -
• Use of the Term, "Diffuse"? (Inf-Ant-Lat OMI) — February 12, 2022 -
• 40yo woman with RVOT VT (MY Comment) — February 14, 2022 -
• CO Poisoning (J-Point vs Terminal QRS Distortion) — Feb. 18, 2022 -
• 40yo man with CP- OMI ECG Signs- LA-LL Reversal — Feb. 22, 2022 -
• Subtle Post. OMI- Technically Inadequate ECG! — Feb. 25, 2022 -
• 40yo with worrisome ST Elevation but Tachycardia! — March 3, 2022 - 
• 80yo woman with SOB — All about RVH! — March 6, 2022 - 
• Memorize those Squiggly Lines (11/12 leads- OMI! )- March 9, 2022 -
• Pendell: 60m-Seizure ( vs Vent. Standstill/Mobitz I) - March 14, 2022 -
• SSmith: Giant U-Waves ( + LVH,RAA,RVH- HypoK )- March 18, 2022 -
• SSmith: I was reading ECGs (3:1 AFlutter/Computer)- March 20, 2022 -
• Pendell: Pathognomonic (BTWI & ER-ST Variation! ) - March 22, 2022 -
•        (also shows benign T wave notching! )
• 
  
• SSmith (Deep): Subtle OMI-VT Criteria- Low Voltage - March 23, 2022 -
• SSmith (Deep): Evidence of OMI? (T-Imbalance V1-V6) - March 26, 2022 -
• Pendell: Woman 50s-SOB-large Acute PE (QR in V1) - March 28, 2022 -
• JesseM: LBBB + OMI (SSmith on Modified Sgarbossa!)- March 31, 2022 -
• Pendell: Man in 50s — Asymptomatic VT! for ? duration - April 2, 2022 -
• Diffuse ST Depression in 35yo with Chest Pain and WPW - April 5, 2022 -
• SSmith: Will Cath tell if ECG is OMI? (subtle - RBBB)- April 11, 2022 -
• Pendell: Man in 50s: CP-serial ECGs-DELAY for OMI - April 13, 2022 -
• Pendell: Woman-30s: CP- ST elev in V2-OMI-FLAG/AIVR - April 8, 2022 -
• SSmith: Ant. ST Elevate? (V1,V2- LVH-Brugada-2-K=6.1)- April 17, 2022 -
• SSmith: ST Elev./Dep. on a Monitor? (Filter Settings)- April 20, 2022 -
• JesseM: CP, Normal ECG- OMI missed (ETT, History)- April 22, 2022 -
• Pendell-Magnus: WPW (AFib @250 -AVRT-Cabrera)- April 24, 2022 -
• SSmith: RBBB/LAHB- Abnl ST-T Waves (Me on BBB)- April 26, 2022 -
• Pendell-Goss: 40m-RUQ Pain- Acute PE (My Table)- April 28, 2022 -
• Pendell: Man-40s (ME-subtle 2:1 Block-PM Cardio App)- May 1, 2022 -
• JesseM: Posterior OMI-Mirror (Low voltage/Technical) - May 3, 2022 -
• Pendell: Confusing (LA-RA Reversal-Brugada-Hyper-K)- May 5, 2022 -
• SSmith: Unstable Angina Exists (ME on Atypical CP) - May 8, 2022 -
• Pendell: Quiz Post — OMI or Nl? (S.African Flag Sign) - May 11, 2022 -
• SSmith: 30yo (Regular WCT-AVRT-vs- Idiopathic VT)- May 14, 2022 -
• Pendell: Asthma- BTWI vs Wellens (Trop p-running-WAP)- May 19, 2022 -
• JesseM: Quiz — Inf ST Elev- Omi? (Early Repol- ME) - May 23, 2022 -
• SSmith: CP + Troponin-Myocarditis (LA-LL Reversal)- May 24, 2022 -
• Pendell: Back to Basics-OMI (SA Block-Leads III,aVF) - May 25, 2022 -
• SSmith: Does single Troponin R/O? (LA-LL Reversal)- May 27, 2022 -
• SSmith: Occlusion MI? (T-Imbalance V1-V6- OMI? ) - June 1, 2022 -
• JesseM: Acute OMI on ECG but not on Cath (MINOCA)- June 5, 2022 -
• Pendell: GSW-Heart (Traumatic Pericarditis- Review!)- June 8, 2022 -
• SSmith: Acute OMI vs Acute Pericarditis - June 11, 2022 -
• Pendell: 30yo with CP/AS (Subtle ECG OMI- LVH) - June 17, 2022 -
• JesseM: LVH and repeated ED Visits for Chest Pain - June 20, 2022 -
• SSmith: LBBB with marked ST-T wave changes! - June 23, 2022 -
• Pendell: LVH-difficult ECG; Need to Repeat the ECG!- June 25, 2022 -
• SSmith: PseudoNormalization-Wellens-Serial ECGs- June 29, 2022 -
• SSmith: Unstable Angina-2 (ME-Diastolic Dysfunction)- July 2, 2022 -
• SSmith: The ECG Must be at Right Time (Subtle OMI)- July 4, 2022 -
• Pendell: Instant "Easy Save" (deWinter T-waves) - July 11, 2022 -
• Pendell: Not Convinced of STEMI (890-Cath-Osborn)- July 13, 2022 -
• SSmith: Middle-aged Male with GERD (subtle OMI) - July 16, 2022 -
• JesseM: 90yo-CP,RBBB-STEMI Neg (Location-Shape)- July 18, 2022 -
•    — Shape - Proportion & Location !!! (to assess for OMI) —
• 
  
• Pendell: 40yo Woman - Nausea - Reverse Takotsubo - July 21, 2022 -
• Pendell: Covid-pos: Myocarditis vs Acute OMI - July 25, 2022 -
• JesseM: How to Assess for OMI with marked LVH? - July 29, 2022 -
• — Shape - Proportion & Location !!! (to assess for OMI) —
• 
  
• Pendell: Man 60s — LBBB-subtle OMI (Qualitative) - August 1, 2022 -
• SSmith: Serial ECGs-Ant. OMI (Pacer- Laddergram) - August 3, 2022 -
• Pendell: Multi-Chest Trauma (Me) Cardiac Contusion - August 6, 2022 -
• SSmith: Wellens' Syndrome (Me)- (may mimic Inferior MI) Aug. 12, 2022 -
• Pendell: Woman 30s — CP, LVH and OMI (Tall T waves) August 15, 2022 -
• SSmith: Rapid AFib not Post OMI (Me) LA-RA Reversal!- Aug. 17, 2022 -
•    — Links to other Lead Reversals on Dr. Smith's Blog!  
• 
  
• JesseM: 60yo-Sepsis-Wellens? (Infarction-Type 1,2 MIs! ) - Aug. 19, 2022 -
• SSmith: Very Fast SVT (Adenosine-induced RBBB) - August 23, 2022 -
• Pendell: Tapping Artifact (Me) - Einthoven's Triangle - August 26, 2022 -
• SSmith: Unstable Angina/HS Troponin (Me)- Hyper-K+ - Sept. 5, 2022 -
• Pendell: 2 Patients with CP (Which has acute OMI? ) September 9, 2022 -
• Pendell: Man 60s — LBBB-OMI-Sgarbossa-Qualitative- Sept. 11, 2022 -
• JesseM: CP, high Trop (STEMI vs OMI-diagnostic PVC) Sept. 13, 2022 -
• SSmith: Woman Agitated (Takotsubo-Giant T-waves)- Sept. 19, 2022 -
• SSmith: Post Leads = False Reassurance (Mirror Test) - Sept. 21, 2022 -
• Pendell: 50m-CP- Early deWinter T-wave Pattern (Me) - Sept. 22, 2022 -
• Emre Aslanger: (Prox LAD OMI- Misdiagnosed) - September 25, 2022 -
• SSmith: All Changes from LVH? (LVH vs Acute OMI) - Sept. 30, 2022 -
• Pendell: CP 1 day after Nl Stress Test (ME-Rhythm! ) - Oct. 3, 2022 -
• SSmith: Activate the Cath Lab? (LVH-V1,V2-BTWI- Me!) Oct. 6, 2022 -
•                        (Great TABLE  on Nl Variant ST Elev/T inv. )
• 
  
• Pendell: Cardiac Arrest & STE (Acute PE on ECG) - October 10, 2022 -
• JesseM: Acute Post OMI despite WPW! - October 13, 2022 -
• Pendell-SSmith: Precordial Swirl (vs LVH-"Strain") - October 15, 2022 -
• SSmith: Is there T-QRS-D (Terminal-QRS-Distortion)? October 17, 2022 -
• SSmith: Problematic Pacer? (Sensing? - Pacing?) - October 19, 2022 -
• Pendell: The Rhythm? (VT ARTIFACT- RA Electrode)  October 21, 2022 -
• SSmith: REPOST (3/28/2017) Serial T-waves-OMI - October 23, 2022 -
• Pendell: The Rhythm? (Reentry SVT- RP' interval) October 25, 2022 -
• SSmith: Abused Medic (Pacer- ST Elevation-OMI) - October 28, 2022 - 
• SSmith: was "Reading EKGs" (Swirl vs LVH- T-QRS-D) November 1, 2022 -
• JesseM: 90yo with CP-Ab Pain (Diffuse Subendo Isch) November 4, 2022 -
• SSmith: Bizarre ECG (Pulse-Tap Artifact-V1,V2- ME) November 8, 2022 -
• Pendell: Elderly Woman (Simult. Leads-OMI-RBBB/LAHB) Nov. 11, 2022 -
• Emre Aslanger: Sometimes STEMI not Enough - November 13, 2022 -
• Pendell: Mistaken Ventricular Bigeminy (vs WPW) November 19, 2022 -
• Pendell: 70m CP — Subtle OMI (KEY is lead V3) - November 23, 2022 -
• SSmith: ST V1,V2-Trop 6500 (Brugada-Car Contusion) - Nov. 25, 2022 -
• Pendell: 20f - Pericardial Effusion/Low Voltage) - November 28, 2022 -
• SSmith: ED MD "Nothing much" (MINOCA- OMI) - November 30, 2022 -
• SSmith: Hyperacute T waves? (Pulse-Tap Artifact!) December 5, 2022 -
• JesseM: 65yo-Syncope (subtle- "Silent" OMI) - December 6, 2022 -
• SSmith: 60yo-Shock- Unusual "hyperacute" -RAD ECG- Dec. 10, 2022 -
• Pendell: On its Way from OMI to Reperfusion - December 12, 2022 -
• Pendell: Marked LVH and acute LAD OMI - December 14, 2022 -
• SSmith: WPW - Huge Delta Waves! (OMI?-DRichley) - Dec. 16, 2022 -
• Pendell: 70yo "Eye-Catching" ECG (Aortic Dissection) - Dec. 18, 2022 -
• Emre Aslanger: OMI (V1,V2,V3 off- post leads) - December 18, 2022 -
• Emre Aslanger: OMI vs STEMI Philosophy in Action! - Dec. 22, 2022 -
• SSmith: 30-something (subtle KEY Findings-OMI- ME) Dec. 23, 2022 -
• SSmith: A diagnostic OMI that may look "nonspecific" - Jan. 2, 2023 -
• Pendell: 50s,f- An OMI with Delay of Cath - January 6, 2023 -
• Pendell: A Teenage Male with CP (OMI in Young Pts) Jan. 9, 2023 -
• Pendell: 2 ECGs — Repol or OMI? (S. African Flag) January 12, 2023 -
• SSmith: Subtle OMI (LA-LL - V1,V2 - Serial ECGs-OMI) Jan 15, 2023 -
•    — (This post published again on June 25, 2024 ! ) —
• 
  
• SSmith: Pulse-Tap Artifact (Links to other artifact) - January 17, 2023 -
• JesseM: Hypothermia-Hypothyroid-Coma (BRogers) Jan. 21, 2023 - 
• Alex Bracey: The Hint from the ICD (Mirror Test-OMI) - Jan. 23, 2023 -
• KG: MY CASE — A Long AV Wenckebach Cycle - Jan. 26, 2023 -
• Pendell: CP in Middle-Aged F (Missed Acute OMI!) - Jan. 28, 2023 -
• JesseM: Dueling OMIs (ME: Not to Miss this OMI) - Feb. 1, 2023 -
• SSmith: Repost from 2020 (EMS ECG-Voltage cut! ) - Feb. 4, 2023 -
• Pendell: 60s Man/CP (I review why OMI missed!) - Feb. 6, 2023 -
• SSmith: What is ECG Diagnosis? (deWinter T-waves) Feb. 10, 2023 -
• SSmith: What Going On in V2,V3? (subtle RVH! ) - Feb. 12, 2023 -
• JesseM: Two 70s with CP (subtle OMI Findings) - Feb. 13, 2023 -
• SSmith: CP & Many C/O (short QTc- Hyper-Ca++) - Feb. 17, 2023 -
• Pendell: Man 40s, Ab Pain (Emery Phenomenon) - Feb. 23, 2023 -
• SSmith: Hyperacute T waves (Me) Hyper-K PEARLS) - Feb. 27, 2023 -
• Pendell: Anaphylax-CP-Diffuse Subendo Ischemia - March 1, 2023 -
• SSmith: CP & SOB — S1Q3T3 & Acute PE Dx - March 4, 2023 -
• SSmith: What to Think of ECG? (Me- Lots on OMI) - March 6, 2023 -
• Pendell: Man in his 50s (OMI-TQRSD- Errors !!!) - March 9, 2023 -
• SSmith: CP-Wellens on EMS ECG (Me- OMI) - March 13, 2023 -
• SSmith: Strange about this PAF? ( = Slow AFib) - March 15, 2023 -
• Pendell: 50yof with CP (Pulse-Tap Artifact) - March 17, 2023 -
• SSmith: 50yom with CP (Not a "Non-STEMI" !) - March 19, 2023 -
• Pendell: Teaching Others (Post OMI- Mirror) - March 21, 2023 -
• JesseM: OMI sent Home (SSmith on Troponin) - March 24, 2023 -
• SSmith: 40yo-OMI Delay (Mirror-leads III-aVL-RV) - March 27, 2023 -
• KG-SSmith: Puzzling rhythm? (MY Case- Mobitz I)- March 30, 2023 -
• SSmith: a STEMI-neg OMI (the PM Cardio APP) - March 31, 2023 -
•      — Great example of T-QRS-D in my comment …
• 
  
• SSmith: the PM Cardio APP (No OMI-abnl ECG-LVH) - April 2, 2023 -
• JesseM: 70yo- OMI Delay (ME details Why OMI) - April 4, 2023 -
• SSmith: Wenckebach + RBBB/LAHB (Trifascicular?) - April 6, 2023 -
• Pendell: OMI with flat ST-T waves & CP Hx - April 9, 2023 -
• Pendell: Man 60s: LVH-Strain vs Ant. OMI (Lead V4) - April 14, 2023 -
• Pendell: Compare Case #1 & 2 (LVH Fake-deWinter) - April 17, 2023 -
• JesseM: 50yo- "normal" ECG (Must correlate CP! ) - April 21, 2023 -
• SSmith: 25ish with CP (Myocarditis- Cardiac MRI) - April 25, 2023 -
• SSmith: 50yo CP (Post. OMI-Mirror - MY LINKS) - April 29, 2023 -
• Pendell: 60f- large T waves (subtle AFlutter- ME! ) - May 1, 2023 -
• KG-SSmith: An Unusual Bradycardia (MY Case) - May 5, 2023 -
• Pendell: 70m-CP (Pacer ECG - obvious STEMI) - May 8, 2023 -
• SSmith: 30f-Atypical CP-Neg CTCA (Wellens- ME!) - May 10, 2023 -
• SSmith: Strange ECG? (Missed LA-RA Reversal! ) - May 13, 2023 -
•     — Initially missed the LA-RA Reversal/Nl variant ST elev./T inv. —  
• 
  
• Pendell: 30s-m-CP (Not OMI - Pericarditis? - ME! ) - May 16, 2023 -
• SSmith: 45-m-jaw pain (OMI from Hx + ECG - ME! ) - May 18, 2023 -
• SSmith: Elder fall (Flecainide Toxicity-Wide QRS) - May 21, 2023 -
• Pendell: 40s,m-CP (OMI- Ignore Computer-V1,V6) - May 23, 2023 -
• SSmith: 20s-m (Verapamil OD-Laddergram-Mobitz I)- May 26, 2023 -
• SSmith: 50s- (RV MI-Shock- LA-RA Lead Reversal) - May 30, 2023 -
• SSmith: 67f- Acute Prox LAD OMI missed!-deWinter- May 31, 2023 -
• Pendell: 30s - Regular WCT- ARVC (not RVOT VT! ) - June 3, 2023 -
• SSmith: 40yo- Cardiology & computer missed OMI! - June 5, 2023 -
• SSmith: 50f- CP-Peaked T Waves- Not OMI! (V1,V2) - June 6, 2023 -
• 
  
•                         — I was on vacation ...  —
• 
  
• SSmith: DKA-Cardiomyopathy (Pt in a regular WCT) - June 23, 2023 -
• KG: MY CASE: Isorhythmic AV Dissociation/PACs - June 26, 2023 -
• SSmith: Young man Regular WCT (Antidromic AVRT) June 28, 2023 -
• SSmith: Texted 2 serial ECGs (Dynamic Repol/BTWI) - June 30, 2023 -
•      — for referencing Repol Variants showing "dynamic" change! —
• 
  
• SSmith: Texted Pt with CP (Bizarre ECG ==> HCM?) - July 5, 2023 -
• SSmith: Texted 80yo-CP-SOB-QOH (RVH-post MI?) - July 7, 2023 -
• SSmith: 60yo with CP (WHY it's Not OMI despite V3) - July 10, 2023 -
• SSmith: Reading ECGs (Pseudonormalization- OMI!) - July 12, 2023 -
• SSmith: 40yo-VFib (Post-ROSC ECGs- à la Shark Fin)- July 14, 2023 -
• KG: MY CASE (+SSmith)To Try Adenosine? (Sinus Tach) July 19, 2023 -
• Pendell: 70yo m-Syncope,Fever (Brugada Phenocopy) - July 22, 2023 - 
• SSmith: Mimic-Vertigo (ME - History needed for Interp! ) July 26, 2023 -
• SSmith: Inf. ST Dep (Amphetamines- Type II MI- LVH) - July 27, 2023 -
• Pendell: Post OMI (subtle Mobitz I — Ladder-PEARLS!) July 30, 2023 -
• MHellerman: OMI Pocket Guide (https://omiguide.org/)- Aug. 3, 2023 -
• SSmith: 1 Hour Lecture — Acute OMI by Dr. Smith! - August 6, 2023 -
• JesseM: 14 hrs of CP: Reperfusion T-waves (PVC ST) - Aug. 10, 2023 -
• Pendell: Subtle AFlutter-RVH (ME- Reg SVT-qR in V1) - Aug. 14, 2023 -
• JesseM: 75yo-No CP (Silent MI- OMI- 5 Problems-ME) - Aug. 19, 2023 -
• Pendell: 70f-CP-wax-waning (ME- Recognizing OMI) - Aug. 30, 2023 -
•       NOTE: I added Laddergrams re the Group Beating! — 
• 
  
• SSmith: 50s-CP- subtle OMI (ME- Lead V1 ST elev.) - Sept. 1, 2023 -
• SSmith: 50s-CP-OMI-890 (ME- Lead aVL T wave) - September 3, 2023 -
• SSmith: Artifact + computer neg — ME = acute OMI! - Sept. 5, 2023 -
• JesseM: 50yo in Remote place (OMI- Cards missed) - Sept. 8, 2023 -
• Pendell: Judge for Yourself (ME - OMI not NSTEMI) - Sept. 10, 2023 -
• SSmith: 40yo-Nonspecific Sx (short QTc- Hyper-Ca++) Sept. 12, 2023 -
• SSmith: 60yo - APTA (Arterial Pulse Tap Artifact) - September 15, 2023 -
• MagnusN: Acute Prox. RCA OMI (RV MI- Echo) - September 17, 2023 -
• SSmith: Regular WCT (AV Dissociation-Fusion) - September 20, 2023 -
• SSmith: Repol T Waves vs OMI (1 or 2 abnormal leads)- Sept. 22, 2023 -
• MagnusN: OMI-ECG Dx (not Morphine) the Problem - Sept. 24, 2023 -
• SSmith: Which Pt has More Severe CP? (OMI? )- September 26, 2023 -
• MagnusN: Shark Fin — then VT, AVRT (ME-Rhythm) - Sept. 27, 2023 -
• Pendell: Ectopic ATach — Emery — SVT Dx - September 29, 2023 -
• Pendell: Repost — Acute OMI that was Missed (ME !) - October 1, 2023 -
• MagnusN: Rhythm (AIVR usurps Mobitz I - LADDER)- October 3, 2023 -
• SSmith: "Culprit" Artery? (ME - on unusual deWinter) - Oct. 6, 2023 -
• MagnusN: Which Patient(s) Need Immediate Cath? - October 8, 2023 -
• MagnusN: What Scenario BEST? (ME-Takotsubo) - October 12, 2023 -
• SSmith: Was texted this ECG (ME- Subtle OMI ) - October 13, 2023 -
• Pendell: Did You See? (ME- Low Voltage-subtle OMI) Oct. 16, 2023 -
• SSmith: Repost- Oct. 13 (ME- Why QOH was Wrong) - Oct. 17, 2023 -
• MagnusN: 20yof — Takotsubo- (ME - Torsades !!! ) - October 18, 2023 -
• JesseM: 4 ECGs — Computer missed OMI !!! - October 19, 2023 -
• SSmith: 70m with Resp. Distress (ME — SVT vs VT)- October 21, 2023 -
• AlexBracey: Electrical & T-Wave Alternans (ME) - October 23, 2023 -
• Pendell: ETOH-Cipro-Lytes (ME- LIST- long QTc!) - October 25, 2023 -
• SSmith: AI YouTube Video (Drs. Kashou & Herman) - Oct. 26, 2023 -
• SSmith: 20ish HCM (Hypertrophic CardioMyopathy) - October 28, 2023 -
• SSmith: NSTEMI a Useless Term! (Lead V2 is KEY- ME)- Oct. 30, 2023 -
• SSmith: RBBB with ST up in V2 - ME (Need Info! ) - November 1, 2023 -
• SSmith: Man 70s — Died (deWinter T-Waves- LBBB) - Nov. 3, 2023 -
• MagnusN: Wide QRS Similar to Prior (ME- paced OMI) - Nov. 5, 2023 -
• SSmith: Intermittent LBBB (Memory vs Ichemia) - November 9, 2023 -
• SSmith: 90yo-CVA (bizarre ECG- not OMI, not Mobitz I)- Nov. 11, 2023 -
• SSmith: 62yo-CP (Serial and Old ECG invaluable! ) November 13, 2023 -
• SSmith: 70f-CP (Pos. Trop- Neg. Cath- MINOCA- ME! ) - Nov. 16, 2023 -
• SSmith: Dyspnea (RBBB- not PE but LV Aneurysm) - Nov. 18, 2023 -
• SSmith: 63m-DKA,Dyspnea (Aslanger's Pattern- ME! ) - Nov. 22, 2023 -
• JesseM: 45yo-CP (Serial ECG Changes but No OMI! ) - Nov. 27, 2023 -
• Pendell: 2 Similar ECGs (LVH-"Swirl"- Truncation- ME!)- Nov. 29, 2023 -
• AlexBracey: Teen with CP (OMI vs Myocarditis- Peds MI)- Dec. 5, 2023 -
• SSmith: LINK to WEBINAR on Acute OMI (My Comment)- Dec. 5, 2023 -
•   My Retrospective Comment on June 18, 2013 post (Dec. 6, 2023) -
• 
  
• WillyFrick: SCAD- LAD OMI (ME — 5 Serial ECGs) - December 7, 2023 -
• SSmith: 50yo-Syncope-No CP (Acute OMI mimic! ) - December 9, 2023 -
• WFrick: 70sf — intermittent CP (ME - Correlate Sx-ECG!) - Dec. 11, 2023 -
• SSmith: The Proportionality Concept (Low Voltage- ME! ) Dec. 13, 2023 -
• MagnusN: Suble OMI (Cabrera- ST Elev. only in aVL) December 16, 2023 -
• WFrick: T-QRS-D — MINOCA — Comparing ECGs-ME! - Dec. 19, 2023 -
• SSmith: Is there an OMI on this ECG? (LCx OMI- ME! ) - Dec. 22, 2023 -
• Pendell: Palpitations 20f (AFlutter @200/min- Schamroth) - Dec. 24, 2023 -
• SSmith: HOCM getting an Angiogram (ME- Apical HCM) - Dec. 26, 2023 -
• WFrick: False Reassurance from Repol. (ME- I see OMI! ) - Dec. 27, 2023 -
• JesseM: CP but "No Ischemic Changes" (ME- subtle OMI) - Dec. 30, 2023 -
• EAslanger: Use of Cannon Waves to diagnose VT-(ME!)- January 1, 2024 -
• Pendell: EMS told "No STEMI" (ME- comparing ECGs) - January 3, 2024 -
• WFrick: 3 Normal Troponins-CATH films! (ME- Morphine)- January 5, 2024 -
•                                    —  —  —  —  —  —  —  —  —   
• WFrick: RA-LL Lead — ME - LIST of Reversals - Artifacts - Jan. 6, 2024 -
•                                    —  —  —  —  —  —  —  —  —  
• SSmith: 40yof with CP & SOB (ME- acute PE ECG Dx) - January 8, 2024 -
• MagnusN: How to Manage this Pt? (ME- on Why VT!) - January 10, 2024 -
• WFrick: Atrial Pacing Troubleshooting (ME- FILTERs) - January 13, 2024 -
• WFrick: Noisy, Low Amplitude ECG (ME- ARTIFACT) - January 15, 2024 -
• JesseM: 2 Patients with CP (ME- My ECG "Mantras") - January 17, 2024 -
• Pendell: 30yom- CP dx'd as NSTEMI (ME- deWinter) - January 20, 2024 -
• MagnusN: "Slow- then Fast ..." (ME- Mobitz I vs II-Ladder)- Jan. 23, 2024 -
• SSmith: CP with LVH and known CAD (multivessel CAD) - Jan. 25, 2024 -
• JesseM: Should this "Nl" ECG Wait? (ME- definite OMI)- January 27, 2024 -
• SSmith: CP in 40yom (Benign Saddleback vs OMI?) - January 29, 2024 -
• SSmith: LV Aneurysm vs NOMI (ME- I can't be sure! ) January 31, 2024 -
• Pendell: What is this? (ME- Huge Osborn Waves!) - February 2, 2024 -
• SSmith: To implement QOH? (ME- OMI-Reperfusion) - February 4, 2024 -
• Pendell: Teenager trauma (ME- Cardiac Contusion) - February 6, 2024 -
•                                   —  —  —  —  —  —  —  —  —
• WFrick: Dyspnea in 90f (ME- PTA, Pacer- ARTIFACT) February 18, 2024 -
•                                   —  —  —  —  —  —  —  —  —
• SSmith: 10 OMI Cases Computer Called Normal (ME! ) - March 4, 2024 -
• SSmith: Irregular AIVR in GSW (Group Beating in AIVR! )- March 7, 2024 -
• 
  
• WFrick: Precordial Swirl (Fascicular Escape- Ladder) - March 22, 2024 - 
• MagnusN: VT in Patient with ARVD (ME- Epsilon waves) March 24, 2024 -
• SSmith quotes ME: Regular WCT that is not VT! - March 28, 2024 -
• Pendell: Another acute Post. OMI missed! (ME- Mirror)- March 31, 2024 -
• MagnusN: CP in Young Man (Acute Myocarditis-Cabrera)- April 11, 2024 -
• SSmith: RBBB/LPHB ( ME 11/12 leads = acute LAD OMI )- April 16, 2024 -
• JesseM: 70m-Bayes Theory= Hx is KEY (ME-PVC = OMI) - April 19, 2024 -
• SSmith: CP resolved: Need Cath? (ME- Wellens' Type A) - April 22, 2024 -
• Pendell: Outperform STEMI Criteria (ME- within seconds!)- April 27, 2024 -
• SSmith: What is the Rhythm? (ME- Hyper-K -neg T wave) April 30, 2024 -
• SSmith: Shock/Nasty ECG (LMain- Shark Fin- Rhythm?) - May 3, 2024 -
• SSmith: Young Man (orthodromic AVRT- AFib-WPW- ME) - May 8, 2024 -
• SSmith: Why in Shock? (RV MI-OMI- AIVR- 10-sec. Dx-ME) May 10, 2024 -
• Pendell: 60m- LAD OMI (Artifact-Filter- subtle ECG- ME) - May 18, 2024 -
• JesseM: OMI missed by Cards (3rd-deg to subtle Mobitz I ) May 27, 2024 -
• Pendell: 2 Patients — Neither is an OMI (I wasn't certain! ) - May 29, 2024 -
• MagnusN: Not OMI — but instead RVH! (ME) — May 31, 2024 -
• SSmith: 2 OMIs that were missed! (ME — AFlutter-Ladder)- June 3, 2024 -
• Magnus: Nl Cath and CP (MINOCA- vagotonic block) - June 5, 2024 -
• JesseM: Serial ECGs: What Sequence? (ME- Correlate!) - June 7, 2024 -
• SSmith:  Marked Hyper-K+ (ME- Is ECG #2 ARTIFACT? ) - June 10, 2024 -
• Pendell: OMI Missed (ME — Repol Mimic- Why OMI) - June 11, 2024 -
• SSmith: Malpractice on OMI missed! (ME- on Why/QOH)- June 13, 2024 -
• WFrick: Telemetry ARTIFACT !!! (ME - LIST !!! ) — June 15, 2024 -
• Pendell: Deadly Triage ECG Missed (ME- acute PE Table) - June 17, 2024 -
• SSmith: 82yo with pacer, shock (ME- Pt had Pericarditis!) - June 19, 2024 -
• SSmith: What to do for this Regular WCT (long RP' ?) - June 21, 2024 -
• W.Frick: VFib-Need an ICD? (ME- similar to Wellens? ) - June 23, 2024 -
• SSmith: Subtle OMI (LA-LL - V1,V2 - Serial ECGs-OMI) - June 25, 2024 -
•    — (This post previously published on Jan 15, 2023 ! ) —
• 
  
• Pendell: Syncopes, Pacer (ME- Complex AV Block) - June 27, 2024 -
• SSmith: Cardiac Arrest (LBBB/OMI- Pt needs Cath/PCI) - June 29, 2024 -
• WFrick: OMI in a Pt with Seizures? (ME- Bayes Theorem) - July 2, 2024 -
• SSmith: Reg WCT with 2:1 (ME- AFlutter-calipers-Dig) - July 5, 2024 -
• JesseM: Shows 2 Cases (ME- STEMI vs OMI Paradigm) - July 7, 2024 -
• Pendell: Precordial Swirl after VFib 890 (ME- on Swirl ) - July 9, 2024 -
• SSmith: Hans H Case — Bad Outcome (ME- Fam Med- OMI) July 11, 2024 -
• Pendell: 2 Cases of "Swirl" (ME- Deep Dive on 2 Cases) - July 14, 2024 -
• SSmith: 81m with CP — pseudo-ST elev. is 2:1 SVT- ME - July 16, 2024 -
• Pendell: 80m, Paced (ME- What Kind of Pacing? - OMI?) - July 19, 2024 -
• Magnus: Incessant VT (ME- LMCA on ECG; Quinidine) - July 21, 2024 -
• SSmith: EMS OMI not Seen (ME- Serial Comparison! ) - July 23, 2024 -
• KG: My 4 ECG/Rhythm Podcasts (for Anthony Kashou) - July 24, 2024 -
• SSmith: 890 from Drug O/D (ME- DSI- 2-Step ECG Interp) - July 25, 2024 -
• Magnus: Crochetage Sign- significant ASD (ME- Bayes) - July 28, 2024 -
• SSmith: 2 ECGs — Is there acute OMI? (ME- deep dive! ) - July 30, 2024 -
• WFrick: Ant. ST Elevation — Surprise Cath! (ME- RV MI) - August 2, 2024 -
• Pendell: What does this ECG show? (ME- Pericarditis! ) - August 4, 2024 -
• Magnus: 3 Pre-Hospital ECGs (ME- OMI-LBBB-Myocard)- August 6, 2024 -
• WFrick: 46m with CP (ME- OMI on AIVR, LADDER) - August 9, 2024 -
• JesseM: 75yo EMS-Acute LAD OMI (ME- Rhythm, OMI)- August 11, 2024 -
• WFrick: Disappearing P waves? (ME- SA Block, LADDER) Aug. 14, 2024 -
• Pendell: CP and a rare combination (ME- acute OMI-WPW) Aug. 16, 2024 -
• Pendell: Back to Basics (Pacemaker Malfunction- ME) - August 19, 2024 -
• SSmith: 69yo- CP- Sam Ghali (ME- RBBB,CABG- OMI)- August 20, 2024 -
• Magnus: Bizarre wide QRS (ME- Brugada-1; PMVT) - August 23, 2024 -
• SSmith: RUQ Pain- acute OMI- Tall R in V2; Women- ME- Aug. 26, 2024 -
• Magnus: "Seizures" in 30f (ME- QTc- long QT LIST! )- September 2, 2024 -
•     — Torsades de Pointes (How to spell? )
• 
  
• Magnus: Ventricular Septal Rupture (ME- "Silent" MI) - Sept. 5, 2024 -
• SSmith: 70m- Wellens' Syndrome (ME- Compare ECGs)- Sept. 7, 2024 -
• WFrick: LAD OMI- Cath films! (ME- Precordial Swirl)- September 9, 2024 -
• SSmith: Syncope-CPR (LV Aneurysm vs LAD OMI) September 11, 2024 -
• Pendell: RBBB- acute LAD OMI (ME- on Serial ECGs) - Sept. 13, 2024 -
• Magnus: Pause-dependent Torsades (ME- Ashman)- Sept. 16, 2024 -
• SSmith: Neg Cath-no R/O OMI-IVUS (ME- Spasm? )- September 18, 2024 -
• SSmith: Syncope during Exercise (ME- SVT at 280/min) - Sept. 20, 2024 -
• WFrick: ST Elevation in III,aVR,V1 (ME - Acute PE)- September 23, 2024 -
• Hans/SSmith: Cardiologys says "Normal" (ME- Errors! ) - Sept. 25, 2024 -
• JesseM: 45yo woman (ME- hyperacute T, OMI - SCAD) - Sept. 27, 2024 -
• SSmith: 50yo VFib (ME- Predict "culprit" not academic) - Sept 29, 2024 -
• KG: MY CASE: (VT in a Sick Patient? = Sinus Tach) - October 1, 2024 -
• SSmith: CP in a 30yo m (Looks like no OMI = "Fake" ) - October 3, 2024 -
• SSmith: Belgium Case (ME- acute Post-Lat OMI) - October 6, 2024 -
• SSmith: How Terrible Not to Recognize OMI (ME- Ant OMI)- Oct. 8, 2024 -
• Pendell: If QOH was available (ME- interplay Post-RV OMI) - Oct. 10, 2024 -
• BNichols: 91m (ME- No OMI-Osborn-flat II- RA-RL Reversal) Oct. 12, 2024 -
• SSmith: Which of 2 Patients Need Cath? (ME- OMI or Not?) - Oct. 15, 2024 -
• JesseM: CP & RBBB - OMI? (ME- ST segment baseline?) - Oct. 17, 2024 -
• Magnus: ME- DSI evolves to complete LMain Occlusion! - Oct. 20, 2024 -
• SSmith: Dr. Peyronie-FR. (ME-Repeat the ECG-acute OMI)- Oct. 22, 2024 -
• Pendell: Computer misses long QTc (ME- flat long QTc-QU)- Oct. 24, 2024 -
• SSmith: Prehosp Activation — Deactivated! (ME- acute OMI)- Oct. 27, 2024 -
• Magnus: 6 Patients with CP + Saddleback STE- OMI? (ME) Oct. 30, 2024 -
• SSmith: Thrombolytic to Treat this NSTEMI (ME-Rhythm-OMI) Nov. 1, 2024 -
• Magnus: NSVT-Echo Beats-Retrograde (ME-LADDER) November 4, 2024 -
• Magnus: Baseline Wander/Artifact (ME-acute OMI-Artifact!) - Nov. 8, 2024 - 
• Pendell: 70f awakened from Sleep (Test recognizing OMI!)- Nov. 10, 2024 -
• WFrick: How Dangerous this ECG? (Mobitz I vs Mobitz II?) Nov. 12, 2024 -
• SSmith: Prehosp Cath Lab Activation (ME- Missed OMI !!! ) Nov. 14, 2024 -
• WFrick: Simulates BTWI (ME- OMI - not BTWI- 9 Criteria) - Nov. 17, 2024 -
• SSmith: Will Smoot Case (ME- acute OMI; Cards missed!)- Nov. 19, 2024 -
• Pendell: 40f with SOB/CP (ME- acute PE; ant. T inversion) Nov. 21, 2024 -
• SSmith: APTA + very high Trop (ME- Artifact; PVC = OMI) - Nov. 23, 2024 -
• SSmith: 30 Examples- HYPERACUTE T waves (ME!) November 27, 2024 -
• WFrick: Recent MI at Other Facility (ME- subtle new OMI) - Nov. 29, 2024 -
• JesseM: 4 Patients with Inf. STE- OMI? (My Opinion)- December 1, 2024 -
• SSmith: 10 Serial ECGs (ME- subtle OMI- Mobitz I; not II)- Dec. 3, 2024 -
• SSmith: Deflating T Waves (ME- amazing evolution!)- December 6, 2024 -
• Pendell: Older woman-CP (ME- OMI, interesting ECG) December 10, 2024 -
• Magnus and ME — WPW with rapid AFib! (IV Amio) - December 13, 2024 -
• SSmith: CT- Dissect Aneurysm (ME- HT crisis/ Ant. STEMI)- Dec. 16, 2024 -
• WFrick: Chest Pain & Rapid Pacing (ME- Pacing!-LADDER)- Dec. 20, 2024 -
• WFrick: How Good Your Memory? (subtle OMI- 3/13/2024) - Dec. 22, 2024 -
• WFrick: Comfortable with Transcutaneous Pacing? (ACLS) Dec. 24, 2024 -
• WFrick: Palpitations in Cardiology Clinic (ME- VT/AV Diss) - Dec. 27, 2024 -
• SSmith: Dizziness in 40yo (Hyperacute T Waves? Not! ) - Dec. 29, 2024 -
• Pendell: DSI in pt. with CP- Aslanger? (ME- DSI Causes) - Dec. 31, 2024 -
• SSmith: Sepsis, LBBB-Torsades (ME- QTc- wide QRS?)- January 2, 2025 -
• WillyF: 60yo CP OMI with AIVR (ME- LADDER; Fusion) - January 5, 2025 -
•     — includes example of “wrong-vessel PCI” (importance of ECG !!!) —
•  
• Arron Pearce — Excel QTc Calculator (for wide QRS) - January 8, 2025 -
• SSmith: 26yo- Syncope, CP, ST Elev (ME- Repol Changes)- Jan. 9, 2025 -
  
• Pendell: Must Recognize! (LAD OMI- shark fin Technique)- Jan 11, 2025 -
• SSmith: 50yo- CP, Pneumonia (ME- Brugada Phenocopy) - Jan. 13, 2025 -
• SSmith-Hans Helseth: What is a "Normal" ECG? (OMI ) - Jan. 15, 2025 -
• SSmith: South African Flag Sign (reperfusion T waves) - Jan. 18, 2025 -
• SSmith: Type II MI or STEMI? (ME-Rhythm? -LBBB-OMI) - Jan. 21, 2025 -
• Hans: 76m- LBBB and Acute STEMI (ME- qualitative)- January 23, 2025 -
• WillyF: 52m- CP (ME- OMI missed! - Precordial Swirl)- January 24, 2025 -
•      — SSmith gives data as to Harm from Waiting with OMIs! —
• 
  
• Magnus and ME: AFlutter- 1:1-Flec (Dual-Level LADDER)- Jan. 26, 2025 -
• Hans Helseth: 34yo with CP (ME- OMI missed! - Delay) - January 28, 2025 -
• Magnus: "Must Know" ECG = deWinter T-Waves (ME) - January 31, 2025 -
• Pendell: 60s man-VFib in ED (ME - LVH- Lead Overlap)- February 2, 2025 -
• WillyF: Syncope & a short Pause (ME- PAVB, Pacing)- February 4, 2025 -
• Magnus: 50yo unusual idiopathic VT? (ME- Review) - February 6, 2025 -
• JesseM: NSTEMI vs Reperfused (ME- missed Findings!) - Feb. 8, 2025 -
• JesseM: To treat 80yo with K+ = 6.2? (ME- ECG-HyperK+)- Feb. 10, 2025 -
• WillyF: Psych. of Acute MI (ME- LVH,"strain"-not OMI)- February 12, 2025 -
• Pendell: 30m with "burning" pain (ME- not OMI; rSR's' V1)- Feb. 14, 2025 -
• WillyF: Is it Pericarditis? (ME- acute OMI- Errors ... )- February 16, 2025 -
• WillyF: subtle Hyperkalemia (ME- low Ca++/Lessons!) - Feb. 18, 2025 -
• SSmith: PEA Arrest — acute MI Mimic (ME-ECG in SAH)- Feb. 20, 2025 -
• Magnus: 85yo- SOB (ME- post-MI Pericarditis- Rupture) - Feb. 26, 2025 -
• SSmith: "Pay Now or Pay Later" (ME-OMI missed/Errors)- March 1, 2025 -
• Hans Helseth: OMI missed! (ME- Inf-Post OMI missed!) - March 3, 2025 -
• Pendell: What is the Rhythm? (ME- I review WCT = VT !) - March 6, 2025 -
• WillyF: 60f- MVA, hubby died (ME- Broken-Heart CM) - March 8, 2025 -
• Hans Helseth: Cards overlooks (ME- isolated post OMI)- March 10, 2025 -
• JesseM: 50yo- new CP (ME- What is "normal" ECG?) - March 12, 2025 -
• Magnus: CP-OMI (ME- serial ECGs- Don't Give MS! ) - March 14, 2025 -
• WillyF: 60s man (ME- multiple Errors-OMI- GREAT! ) - March 17, 2025 -
•        — Cath not impressive (Need intravscular imaging! )
• 
  
• JesseM: 84yo (ME- post. OMI not NSTEMI- Mirror ) - March 19, 2025 -
• Pendell: 40m- CP (ME- OMI missed- "good chart") - March 23, 2025 -
• WillyF: Localize the "Culprit"? (ME-Basics-Artifact-OMI)- March 25, 2025 -
• SSmith: Missed, even in Retrospect (ME-Compare ECGs) March 27, 2025 -
• WillyF: ST Dep on ECG? (ME- Spasm? When to Cath?) March 30, 2025 -
• SSmith: Wellens' not Repol! (ME- 30yo aa male!) - April 2, 2025 -
• JesseM: Refractory CP (ME- multiple Errors!- LAD OMI) - April 4, 2025 -
• SSmith: Katie B Case — Shock (ME- missed Rhythms) - April 6, 2025 -
• SSmith: Ant. STEMI-VFib (ME- R-on-T, RBBB,Lidocaine)- April 9, 2025 -
• SSmith: We must Advocate for Our Pt (ME- post. OMI) - April 11, 2025 -
• SSmith: Young man with MINOCA (ME-EMS ECGs-OMI )- April 13, 2025 -
• Pendell: 40f, CP (ME- OMI, Rhythm?- RA-RL- Rhythm?)- April 16, 2025 -
• 
  
• Hans Helseth: 84yo- missed OMI (Me-Masquerade (MBBB)
•      — Rhythm with PVCs, Fusion - PVC with ST Elev - April 18, 2025 -
• Pendell: Elderly Pt (ME- Alternans- Pericard Effusion)- April 21, 2025 -
• Hans Helseth: 59m- Hypothermia (ME- ECG-shivering)- April25, 2025 -
• SSmith: Repost- 3/28/2017 (ME- LAD OMI-Hyeracute) - April 27, 2025 -
• Hans Helseth; Junctional Tach vs slow AVNRT- ME) - April 30, 2025 -
• SSmith: Drew's Case (ME- OMI-Great on Serial ECGs!) - May 2, 2025 -
• Hans: "Nl" ECG- persistent CP (ME- Is ECG "Normal"?) - May 4, 2025 -
• SSmith: Seizures & Tachy (ME- Na-Channel Blockade) - May 6, 2025 -
• SSmith: 70m with Fall, Hip Fx- No CP (ME- "Silent" MI) - May 8, 2025 -
• SSmith: Repost from 6/23/2014 (ME- Inf OMI-LADDER) May 10, 2025 -
• Pendell: 60sw — CP (ME- RBBB-LAD OMI, not WPW!)- May 13, 2025 -
• Magnus: Young Male- Pathologic ECG (ME- on BTWI) - May 15, 2025 -
• SSmith: CP; Neg hs-Troponin (ME- ECG not "Normal")- May 17, 2025 -
• Mark Hellerman: Spot this ECG Finding? (ME- LVH, OMI)- May 19, 2025 -
• Magnus: subtle S. African Flag (ME- Effect of Artifact! ) May 21, 2025 -
•     (Great Refs by SSmith on benefits of EARLY vs late PCI !!! )
• 
  
• WillyF: AFlutter + Dual-Level Wenckebach-LADDER) - May 24, 2025 -
• WillyF: 90m-Shoulder Pain (ME- OMI- Lessons re ETT!)- May 26, 2025 -
• SSmith: 30f- obvious missed OMI (ME- prox. LAD OMI) - June 5, 2025 -
• SSmith: Known HOCM- new CP! (ME- OMI despite LVH!)- June 7, 2025 -
• WillyF (Evan's Case): 41m (ME- OMI, unclear details) - June 10, 2025 -
•       — has LINKS to "magic" leads III-aVL reciprocal relationship —
• SSmith: 60m-CABG- new CP (ME- fast Dx of post. OMI)- June 12, 2025 -
• Pendell: 50f- sudden CP (ME- pure Pericarditis- ECGs!)- June 15, 2025 -
• WillyF: 40s man- Anteroseptal ST Elev (ME- acute RV MI)- June 17, 2025 -
• 
  
• 
  
• = = = = = = = = = = = = = = = = = =
•   — TRANSITION to the WORDPRESS SITE (6/23/2025) —
• = = = = = = = = = = = = = = = = = =
• SSmith: Excellent OMI Care (ME- acute prox. LAD OMI) - June 25, 2025 -
• SSmith: Emily Dawra Case (ME- Precordial "Swirl" ) - June 27, 2025 -
• JesseM: 65yo-CP in Dialysis (ME- Aslanger's, IVCD, and
•      use of simultaneously-recorded leads for Rhythm) - June 29, 2025 -
• WillyF: 40s man-10/10 CP (ME- "Swirl"- dynamic ST-T) - July 1, 2025 -
• Magnus: Dx after 20 Years!- not Sz! (ME- CPVT, WPW) - July 3, 2025 -
• SSmith: Regular WCT — (ME- RVOT VT- Idiopathic VT) - July 5, 2025 -
• JesseM: 75yo: 6 Reasons "Not to Cath" (ME-OMI missed) July 7, 2025 -
•     — Great REF for nl 1st, 2nd Trop; STEMI sensitivity- "dynamic"
• 
  
• Pendell: 40m EMS OMI (ME- lead V3 hyperacute-OMI) - July 9, 2025 -
• Magnus: 70f — Long QT Synd (ME- QTc-T/U Alternans) July 12, 2025 -
• Pendell: EMS very wide QRS (ME- HyperK+ ) - July 14, 2025 -
• Emerson Floyd: Acute OMI in a "STEMI World" (ME- OMI)- July 16, 2025 -
• SSmith: An OMI that is a STEMI! (ME- Oversights! ) - July 19, 2025 -
• SSmith: CP and a Fast Rhythm (ME- WCT, Abnl ECG!) - July 21, 2025 -
• Pendell: CP & ST Elev-Cath Lab? (ME- Artifact LIST) - July 23, 2025 -
• SSmith: 70f — CP, ST Elev. (ME- RBBB- needs Cath! ) - July 26, 2025 -
• Magnus: Can You Guess Dx? No Hx. (ME- acute PE! ) - July 28, 2025 -
• Magnus: 87m with CP (ME- acute OMI should see!) - July 30, 2025 -
• SSmith: Cody Pinnow- ETTs (ME- OMI not recognized)- August 1, 2025 -
• SSmith: Accuracy of Cath Lab Activation (ME- QOH)- August 3, 2025 -
• SSmith: Will Smoot case- Neg 1st Trop (ME- acute OMI) - Aug. 5, 2005 -
• Magnus: 35f — post-ROSC ECG (ME-Shark-Fin - VFib) - Aug. 8, 2025 -
• JesseM: 75yom- new CP (ME- OMI-"Swirl"-new RBBB) - Aug. 10, 2025 -
• SSmith: 30m- agitated (ME- regular SVT = Sinus Tach! ) - Aug. 13, 2025 -
• SSmith: 40sm- Cough,SOB,CP (ME- hyperacute? No ) - Aug. 15, 2025 -
• Pendell: 60sm- Acute CP: Swirl? (ME- Nl cath; HCM? ) - Aug. 18, 2025 -
• SSmith: VFib Arrest-HyperK+ (ME- HyperK masks OMI)- Aug. 22, 2025 -
• SSmith: New CP in 15yo (abnl ECG- Trop 11,000- Dx?)- Aug. 25, 2025 -
• SSmith: Severe CP, 50sw (Wellens'-like ECG; Nl Trop) - Sept. 5, 2025 -
• Magnus: 80m- CP, LBBB (ME — acute OMI! ) - September 8, 2025 -
• SSmith: 89w-CP radiating to Back (Aortic Dissect-OMI)- Sept. 10, 2025 -
• Emerson Floyd: 80m- 5 Lessons (ME- prox LAD OMI) - Sept. 13, 2025 -
•                     — LA-RA Lead Reversal ... —
• 
  
• SSmith: Brady Preg ECG (ME-RBBB/LAHB-acute OMI) - Sept. 15, 2025 -
• WillyF: 60sm — Is this Real or a "Fake"? (ME- not OMI)- Sept. 18, 2025 -
• SSmith: 70sm- SOB: Can AI make Dx? (ME- AFlutter) - Sept. 21, 2025 -
• SSmith: 21m- "Viral Syndrome" (ME- ECG = Acute PE!)- Sept. 23, 2025 -
• WillyF: Rapid SVT- Dx? (ME- 1:1 AFlutter/Flec/Adeno) - Sept. 26, 2025 -
• Pendell: 30sm - recurrent Pericarditis! - (ME- Review) - Sept. 28, 2025 -
• Magnus: 90m- new CP (ME- deWinter-RBBB-compare) - Oct. 1, 2025 -
• SGhali: 60yom CP, 890- Video (ME- acute OMI missed) - Oct. 4, 2025 -
• SSmith: 30yom (ME- inf. ST elev. — but no OMI ) - October 6, 2025 -
• SSmith: 39m- Extremely fast (ME- 1:1 AFlutter @300)- October 7, 2025 -
• SSmith: 34 wks Pregnant (ME- ECG Dx/Rx of new AFib)- Oct. 9, 2025 -
•       — My Comment on how AFib sometimes "organizes" (in V1) —
• 
  
• Pendell: 60s f-CP (ME- hyperacute T waves-Pt died)- October 12, 2025 -
• SSmith: 24yo m CP (ME- acute OMI- not myocarditis) - Oct. 15, 2025 -
• SGhali: 45m-"Heartburn"- Video (ME- huge MI-RV MI) - Oct. 19, 2025 -
• WillyF: Emergent Cath (ME-"magic" leads III-aVL- OMI) - Oct. 21, 2025 -
•       — monomorphic VT usually due to "scar" (not ischemic!) —
• 
  
• Magnus: 69f- missed "Swirl"- Pt Died (ME- 12/12 leads)- Oct. 23, 2025 -
• SSmith: Lecture: Replace STEMI with OMI Paradigm! - Oct. 24, 2025 -
• Pendell: 70s-m- CP (ME- OMI missed- Swirl! ) - October 27, 2025 -
• SSmith: 85m - regular WCT ==> subtle AFlutter - October 31, 2025 -
• JesseM: 60f-10/10 CP-rural Hosp. (ME- LAD OMI) - November 3, 2025 -
• SSmith: IRBBB + RVH (ME- Crochetage Sign) - November 6, 2025 -
• SSmith: Atypical Sx; Thrombolytics? (ME- OMI; RV) - Nov. XX, 2025 -
• SSmith: 67f- Can Medics leave Pt at home (ME- OMI)- Oct. XX, 2025 -
• SSmith: 60m- CP, Pulm. Edema (ME- subtle OMI?) - Nov. XX, 2025 -
• SGhali: 55f- "Indigestion"- Video (ME- 10 Pearls! -
•    — 10 Pearls: OMI- "silent" MI - RV MI - post, III-aVL! - Oct. XX, 2025 -
• 
  
• WillyF: 70sf- Narrow Tachycardia (ME- AVRT-LADDER) Oct. XX, 2025 -
• Magnus: 77m- Apical HCM with minimal Voltage- ME) - Aug. XX, 2025 -
• Magnus: 87f- Pacer Troubleshooting (ME- Pacer/Filter) - Aug. XX, 2025 -
• Magnus: 83m- a Special WCT = BiDirectional VT (ME) - Nov. XX, 2025 -
• 
  

• SSmith: 50f- Some OMIs are Atypical (ME- bizarre ECG)- May XX, 2025 -
•  — This was Dx'd as no ischemia. Can be a big problem! NOT Yet! —
• 
  
•      

  

NOT USING (12/8/2024):

• SSmith: REPOST (6/17/2016) Truncated EMS ECG - Sept. XXX, 2022 -
• 
  
•               

 

-------------------------------------------