Shark Fin morphology recognized only by EM physician
This ECG is from a man in his 70s who complained of acute chest pain followed by a witnessed cardiac arrest. This ECG was taken after ROSC following 35 min down time.
This ECG shows Shark-fin morphology with RBBB + LAFB and massive anterolateral ST elevation. The cause was an acute proximal LAD occlusion.
Teach your learners: when the QRS is wide, the J-point will hide, so trace it down and copy it over!
This ECG is from a middle aged man who presented with chest pain and diaphoresis while exercising. He had a VSD repair at age 6.
This ECG shows sinus tachycardia with RBBB + LPFB. ST elevation in III and aVF with reciprocal ST depression in aVL. ST depression in V2-5. The cause was inferoposterior MI, due to severe triple vessel disease and a culprit 100% circumflex occlusion.
How does acute left main occlusion present on the ECG? Case 2
This ECG is from a young woman who presented with sudden pulmonary oedema. This ECG was recorded just before she arrested.
This ECG shows sinus tachycardia, RBBB, LAFB and ST elevation in V2-6, I and aVL. The cause was a 100% left main occlusion.
What is the Diagnosis in this 70-something with Chest Pain?
This ECG is from a man in his 70s who presented with chest pain.
This ECG shows RBBB, LAFB and ST elevation V2-4. The troponin was very high due to a very large infarct. The cause was 3 vessel disease. The rhythm is also grouped, possibly bigeminy.
Two patients with RBBB
This ECG is from a woman in her 60s who presented with dyspnoea, on a background of chronic respiratory disease.
This ECG shows RBBB with ST elevation in I and aVL. All previous ECGs were identical, so this was most likely her baseline ST elevation. Troponins and echo were normal.
What is this rhythm? And what else does it show?
This ECG is from a man in his 60s who presented with abdominal pain dyspnoea and altered level of consciousness, in shock.
This ECG shows wide complex tachycardia with concordant ST elevation in V4-6, due to LAD occlusion. The rhythm was likely sinus tachycardia with RBBB and then LAFB mid way through the trace.