Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


EKG Masterclass

Sean Fox, MD

  • Wide regular tachycardia is VT until proven otherwise
    • Shock if unstable vital signs
  • Wellen's Sign
    • Biphasic T-wave in V2-3
    • Highly specific for LAD occlusion
  • Be cautious of right ventricular MI in the setting of an inferior STEMI
    • Will be pre-load dependent
    • Stay away from nitrates
    • EKG Changes:
      • ST Depression in V2 and ST Elevation in V1
      • ST Depression in V2 with isoelectric V1 and V3
      • ST Elevations of Lead III > II
      • Can also try right sided leads (STEMI in rV4)
  • Hypertrophic Cardiomyopathy
    • LVH is the most common and sensitive sign
    • Look for large narrow Q waves in the lateral leads
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