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Amal Mattu, MD
Professor and Vice Chair
Department of Emergency Medicine
University of Maryland School of Medicine
Baltimore, Maryland
amalmattu@comcast.net
Writing
Handout/PDF
Gold standard Marriott, Chou
www.ekg.umem.org EKG cases of
the week
Advanced video course on emedhome,
books ACEP bookstore
Friction rub
PR depression in multiple leads
(Only reliably seen in viral AP, transient)
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
STEMI or AP?
Causes of STE
STEMI or AP?
STEMI or AP?
STEMI
STEMI or AP?
Acute pericarditis?
Acute pericarditis?
Acute pericarditis?
Diffuse ischemia
Pericardial Effusions
Low voltage + tachycardia = pericardial
effusion until proven otherwise
When in doubt about the ECG baseline,
use the T-P segment!
Pulmonary Embolism
New T-wave inversions are very
common in cases of large PEs
Especially common in anteroseptal leads
Marriott and other others:
Simultaneous TWIs in anteroseptal +
inferior leads is HIGHLY specific for acute
pulmonary hypertension (= PE)
Pulmonary Embolism
Baseline ECG
Baseline ECG
Baseline ECG
#4: Intracranial
Hemorrhage
Intracranial Hemorrhage
Intracranial Hemorrhage
Intracranial Hemorrhage
Previous ECG
Intracranial Hemorrhage
Intracranial Hemorrhage
Intracranial Hemorrhage
Severe Hypokalemia
Severe Hypokalemia
Severe hypokalemia
Remember
Just because electrocardiography is
a basic skill in EM doesn t mean
that our skills should be basic.
YOU must be the experts in
electrocardiography!