Emergency Medicine Cases

ECG cases is a monthly blog by Jesse McLaren (@ECGcases), a Toronto emergency physician with an interest in emergency cardiology quality improvement and education. Each post features a number of ECGs related to a particular theme or diagnosis (with a focus on acute coronary occlusion), so you can test your interpretation skills. We challenge you with missed or delayed diagnosis, those with false positive diagnosis, and those that had a rapid and correct diagnosis. Cases are followed by a quick summary of the literature that relates to the cases, and we bring it home with practice changing pearls that you can use on your next shift.

ECG Cases 26: Pulmonary Embolism and Acute RV Strain

In this month's ECG Cases Dr. Jesse McLaren runs through 10 cases and explains how the ECG can be integral in the diagnosis and management of pulmonary embolism, even though it is not incorporated into any of the commonly used decision tools for diagnosis of pulmonary embolism...

By Jesse McLaren|2024-12-29T17:10:06-05:00October 18th, 2021|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine, Medical Specialty, Respirology|Tags: ECG, ECG cases, pulmonary embolism, RV strain|2 Comments

ECG Cases 25: ‘Late STEMI’ – How acute is the coronary occlusion?

In this ECG Cases blog we look at 10 patients with potentially ischemic symptoms. Which had a coronary occlusion, and how acute were they? Jesse McLaren explains 'Late STEMI' and how reperfusion strategies should not be based on time of symptom onset...

By Jesse McLaren|2021-09-21T15:36:40-04:00September 21st, 2021|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine, Medical Specialty|Tags: Dr. Jesse McLaren, ECG interpretation, STEMI|0 Comments

ECG Cases 24 Reciprocal Change and Occlusion MI

Dr. Jesse MacLaren reviews 10 ECG cases highlighting how reciprocal change can be secondary to LBBB/LVH, primary changes, or both, how it can be the first and remain the dominant sign of occlusion, pointing to subtle ST elevation or hyperacute T waves, how it can can highlight subtle inferior, lateral or proximal LAD occlusions, how it can be the only sign of posterior OMI; and how it can be absent in mid-distal LAD occlusion...

By Jesse McLaren|2021-08-19T08:47:15-04:00August 10th, 2021|Categories: Cardiology, ECG Cases, EM Cases, Medical Specialty|Tags: ECG, ECG cases, occlusion MI, reciprocal change, STEMI|4 Comments

ECG Cases 23 – Wellens syndrome, reperfusion and reocclusion MI

Eight patients presented with potentially ischemic symptoms and T-wave inversions. Which had occlusion MI, which were reperfused and which were reoccluded? Jesse McLaren helps you discover the nuances of Wellens syndrome and T-wave inversions on this month's ECG Cases blog...

By Jesse McLaren|2021-07-13T12:27:47-04:00July 13th, 2021|Categories: Cardiology, ECG Cases, Emergency Medicine, Medical Specialty|Tags: ECG, occlusion MI, T-waves, Wellens|0 Comments

ECG Cases 22: T-wave INVERSION mnemonic

The differential for T-wave INVERSION includes: Incorrect lead placement, No bundle (RBBB, LBBB), Ventricular hypertrophy (LVH, RVH), Embolism, Reciprocal/refractory/reperfused occlusion MI, Sudden death (ARVD), Iatrogenic (digoxin), Obtunded (eg SAH), and Normal variant. Jesse McLaren runs through 10 cases of patients who present to the ED who have T-wave inversions on their ECGs...