Ken Grauer, MD

APRIL 26, 2024

The ECG in Figure-1 — was obtained on the scene by EMS ( E mergency M edical S ervices ). He was hemodynamically stable — but clearly distressed with a sense of “impending doom” at the time ECG #1 was recorded. QUESTIONS: How would YOU interpret the initial ECG in Figure-1 ? Extra Credit: How many beats are seen on this ECG?

EKG/ECG 348

EKG/ECG Resuscitation EMS Wellness 348

Ken Grauer, MD

MARCH 15, 2024

What if you were asked to interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). By the P s, Q s, 3 R Approach ( which I review in ECG Blog #185 ): Lots of P waves are present — being well seen in the long lead II rhythm strip.

EKG/ECG 390

EKG/ECG Wellness 390

Ken Grauer, MD

DECEMBER 29, 2023

QUESTION: HOW would YOU interpret the ECG in Figure-1 — if no clinical information was provided? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). = The ECG in Figure-1 — was obtained following successful resuscitation.

EKG/ECG 388

EKG/ECG Resuscitation Hospitals Wellness 388

Ken Grauer, MD

SEPTEMBER 22, 2023

The ECG in Figure-1 — was obtained from a middle-aged man with palpitations and shortness of breath. How would YOU interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). Figure-1: The initial ECG in today's case. (

EKG/ECG 421

EKG/ECG Wellness 421

Ken Grauer, MD

MARCH 27, 2024

I was sent the ECG in Figure-1 — with the following history: The patient is a young man in his early 20s — who presents to the ED ( E mergency D epartment ) because of SOB ( S hortness O f B reath ) that had been ongoing for several hours. QUESTIONS: In view of the above history — How would YOU interpret the ECG in Figure-1 ?

EKG/ECG 447

EKG/ECG Wellness 447

Ken Grauer, MD

DECEMBER 23, 2023

The ECG in Figure-1 — was obtained from a patient with palpitations. Figure-1: The initial ECG in today's case. My Interpretation of the ECG in Figure-1: Since the patient is hemodynamically stable — there is time for systematic assessment of the rhythm. The patient was hemodynamically stable in association with this rhythm.

EKG/ECG 430

EKG/ECG Wellness 430

Ken Grauer, MD

JANUARY 13, 2024

The ECG in Figure-1 was obtained from a middle-aged man with known hypertension — who presented to the ED ( E mergency D epartment ) for CP ( C hest P ain ) over the preceding 2-3 days. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? The Initial ECG in Today’s CASE: The rhythm in ECG #1 is sinus at 65-70/minute.

EKG/ECG 379

EKG/ECG Hospitals 379

Ken Grauer, MD

SEPTEMBER 1, 2023

Why are there so many shapes for the QRS complex in the long lead II rhythm strip? Figure-1: 12-lead ECG and long lead II rhythm strip obtained after Adenosine was given for a regular SVT rhythm. PEARL # 2: When the rhythm is complex — Look for "normal" beats. second to conduct normally.

EKG/ECG 277

EKG/ECG Administration 277

Ken Grauer, MD

MARCH 11, 2024

I was asked to interpret the 2-lead rhythm strip shown in Figure-1 — without the benefit of any history. Figure-1: You are asked to interpret this 2-lead rhythm strip without the benefit of any history. Although the Q RS complex looks wider than it normally is — the QRS does not measure more than half a large box ( ie, not more than 0.10

EKG/ECG 370

EKG/ECG 370

Ken Grauer, MD

AUGUST 26, 2023

The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. In view of this history — How would YOU interpret this ECG? Figure-1: The initial ECG in today's case. (

EKG/ECG 342

EKG/ECG EMS Hospitals 342

Ken Grauer, MD

FEBRUARY 3, 2024

The ECG in Figure-1 was obtained following successful resuscitation. QUESTIONS: In view of the above history — How would YOU interpret the ECG in Figure-1 ? Is this ECG finding present in today’s initial ECG? Figure-1: The initial ECG in today's case — obtained after successful resuscitation from cardiac arrest. (

EKG/ECG 393

EKG/ECG Resuscitation Hospitals Wellness 393

Ken Grauer, MD

NOVEMBER 4, 2023

Figure-1: How would YOU interpret this ECG? MY Thoughts on the ECG in Figure-1: When faced with a challenging cardiac arrhythmia — It is a "luxury" to have access to a long lead rhythm strip containing 3 simultaneously -recorded leads. Lead V1 offers the best perspective of right -sided QRS morphology.

EKG/ECG 386

EKG/ECG Wellness 386

Ken Grauer, MD

SEPTEMBER 8, 2023

The ECG in Figure-1 — was obtained from an older man with a history of prior infarction and coronary bypass surgery. Figure-1: The ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). The QTc appears to be normal. second in some leads ). Clinical implications?

EKG/ECG 284

EKG/ECG Research 284

Ken Grauer, MD

APRIL 13, 2024

I was sent the ECG in Figure-1 — told only that the patient was 70 years old, and had a history of an ASD ( A trial S eptal D efect ). Serum K+ was normal. The patient was hemodynamically stable with ECG #1. Figure-1: The initial ECG in today's case. QUESTIONS: How would YOU interpret the rhythm in Figure-1 ?

EKG/ECG 284

EKG/ECG Wellness 284

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. How would YOU interpret her post-resuscitation ECG? Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? QUESTIONS: In light of the above clinical history.

EKG/ECG 369

EKG/ECG Resuscitation Documentation/Coding Hospitals 369

Ken Grauer, MD

FEBRUARY 15, 2024

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who presented to the ED ( E mergency D epartment ) for shortness of breath. QUESTIONS: How would YOU interpret the ECG shown in Figure-1 ? Figure-1: The initial ECG in today's case. Figure-1: The initial ECG in today's case.

EKG/ECG 312

EKG/ECG Wellness 312

Ken Grauer, MD

DECEMBER 15, 2023

For full discussion of this case — See ECG Blog #392 — == The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. Figure-1: The initial ECG in today's case. (

EKG/ECG 331

EKG/ECG EMS Hospitals 331

Ken Grauer, MD

JANUARY 26, 2024

I was sent the ECG in Figure-1 — without the benefit of any history. Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). By the Ps, Qs, 3R Approach ( which I review in ECG Blog #185 ): P waves are present — and best seen in lead V1.

EKG/ECG 255

EKG/ECG 255

Ken Grauer, MD

APRIL 5, 2024

The ECG in Figure-1 was obtained from a middle-aged woman — who presented with low back pain, shortness of breath and marked hypertension — but no CP ( C hest P ain ). QUESTIONS: In view of this history — How would YOU interpret this ECG? Figure-1: The initial ECG in today's case. Figure-1: The initial ECG in today's case.

EKG/ECG 231

EKG/ECG EMS Hospitals 231

Ken Grauer, MD

DECEMBER 8, 2023

For full discussion of this case — See ECG Blog #292 — == The 2 ECGs shown in Figure-1 were obtained from a man in his 30s — who presented to the ED ( E mergency D epartment ) with chest pain that began several hours earlier. ECG #2 was recorded 1 hour after ECG #1. (22:3 0 min. Initial troponin was negative.

EKG/ECG 352

EKG/ECG Hospitals 352

Ken Grauer, MD

FEBRUARY 9, 2024

Imagine the only information provided for the ECG in Figure-1 — is that it was obtained from a 60-year old man with new CP ( C hest P ain ). QUESTIONS: In view of this brief history — How would YOU interpret this ECG in Figure-1 ? Is the cardiac rhythm related to the 12-lead ECG?

EKG/ECG 255

EKG/ECG Operations Wellness 255

Ken Grauer, MD

OCTOBER 21, 2023

The ECG in Figure-1 is from an older man with known coronary disease — who presents to the ED ( E mergency D epartment ) with new CP ( C hest P ain ) over the past several days. QUESTIONS: In view of this history — How would you interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. Troponin is pending.

EKG/ECG 239

EKG/ECG Shock Wellness 239

Ken Grauer, MD

APRIL 18, 2023

The ECG in Figure-1 was obtained from a 50-year old man — who presented to the ED ( E mergency D epartment ) with new-onset CP ( C hest P ain ). QUESTIONS: There are at least 3 principal findings on this ECG — some of which deal with a possible “culprit” artery and / or the location of whatever is going on.

EKG/ECG 195

EKG/ECG Wellness 195

Ken Grauer, MD

MAY 20, 2023

The ECG in Figure-1 — was obtained from an older woman with persistent CP ( C hest P ain ) over the previous day. Figure-1: The initial ECG in today's case. Intervals ( PR, QRS and the QTc ) and the frontal plane axis are normal. This is because there is normally a small amount of upward-sloping ST elevation in leads V2 and V3.

EKG/ECG 342

EKG/ECG Wellness 342

Ken Grauer, MD

OCTOBER 27, 2023

The ECG in Figure-1 was obtained from an elderly woman — who presented to the ED ( E mergency D epartment ) for dyspnea on exertion over recent weeks. Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). What are YOUR "Quick Thoughts" about this case?

EKG/ECG 247

EKG/ECG Resuscitation Hospitals Wellness 247

Ken Grauer, MD

JANUARY 26, 2023

The ECG in Figure-1 was obtained from a previously healthy older man — who complained of chest pain and “lightheadedness” while this tracing was recorded. In view of this history — How would YOU interpret the ECG in Figure-1 ? A total of 12 beats are seen in the long lead II rhythm strip. He was not hypotensive.

EKG/ECG 195

EKG/ECG Wellness 195

Ken Grauer, MD

MAY 26, 2023

The ECG in Figure-1 was obtained from a 60-ish year old man with a history of coronary disease ( including prior CABG ) — who presented to the ED ( E mergency D epartment ) with new CP ( C hest P ain ) of 3 hours duration , diaphoresis and nausea/vomiting. The patient was hypotensive at the time his initial ECG in Figure-1 was obtained.

EKG/ECG 195

EKG/ECG Wellness Resuscitation 195

Ken Grauer, MD

JULY 15, 2023

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who while performing his regular exercise routine, developed "slight" chest discomfort and "palpitations". Surprisingly — he was hemodynamically stable with minimal discomfort at the time his initial ECG in Figure-1 was recorded. Could the patient have WPW?

EKG/ECG 195

EKG/ECG Shock EMS 195

Ken Grauer, MD

MARCH 18, 2023

The ECG in Figure-1 was obtained from a man in his mid-60s — who presented with new chest pain. Figure-1: T he initial ECG in today’s case. MY Thoughts on the Initial ECG: The rhythm in ECG #1 — is sinus at ~70/minute. All intervals ( PR, QRS, QTc ) are normal. Should the cath lab be activated?

EKG/ECG 195

EKG/ECG Wellness 195

Ken Grauer, MD

JULY 9, 2023

The ECG in Figure-1 was obtained from a 60-year old woman — who presented to the ED ( E mergency D epartment ) for “palpitations”. Her vital signs were normal at the time this triage ECG was recorded. How would YOU interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case.

EKG/ECG 195

EKG/ECG 195

Ken Grauer, MD

OCTOBER 13, 2023

The ECG in Figure-1 was obtained from a woman in her 60s — who was seen in the ED ( E mergency D epartment ) as part of her evaluation for trauma following a motor vehicle accident. Figure-1: The initial ECG in today's case. To do this — I apply the P s, Q s, 3 R Approach ( See ECG Blog #185 — for review of my system ).

EKG/ECG 361

EKG/ECG 361

Ken Grauer, MD

APRIL 3, 2023

How would YOU interpret this long lead II rhythm strip? Figure-1: The long lead II rhythm strip for today’s case. To improve visualization — I've digitized the original ECG using PMcardio ). As always — I favor a systematic approach to rhythm interpretation, using the P s, Q s, 3 R memory aid ( See ECG Blog #185 ).

EKG/ECG 195

EKG/ECG 195

Ken Grauer, MD

JULY 22, 2023

The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. Some amount of time passed at home — during which his chest discomfort persisted The patient was hemodynamically stable at the time he was seen by EMS, when ECG #1 was recorded.

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

Ken Grauer, MD

JANUARY 20, 2024

I was sent the tracing shown in Figure-1 — told only that this was a preoperative ECG obtained from an asymptomatic older woman scheduled for non-cardiac surgery. How would YOU interpret this ECG? Figure-1: Preoperative ECG from an asymptomatic older woman scheduled for non-cardiac surgery. The 12-lead ECG is very concerning.

EKG/ECG 231

EKG/ECG 231

Ken Grauer, MD

MAY 6, 2023

The ECG in Figure-1 — was obtained from an older woman with chest pain. Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ). The QRS of sinus beats #3,6,9,12 and 15 looks narrow in this long lead II rhythm strip. How would YOU interpret this tracing?

EKG/ECG 195

EKG/ECG 195

Ken Grauer, MD

FEBRUARY 24, 2023

The ECG in Figure-1 was obtained from a previously healthy 30-ish year old man — who presented to medical attention for vasovagal syncope. Based on this initial ECG — the patient was transferred to a PCI-capable center: Do YOU agree with the need for transfer? Figure-1: The initial ECG in today's case.

EKG/ECG 195

EKG/ECG Hospitals Wellness 195

ECG Guru

MAY 24, 2024

ECG Number 1, 11:57 a.m.: There is a wide-complex tachycardia at a rate of about 230 bpm. The PRI given is taken from Lead II, which, along with V5, does have P waves. In the other leads, the P waves are buried in preceding T waves. In the other leads, the P waves are buried in preceding T waves. The QRS is.15

EKG/ECG 98

EKG/ECG Shock Outcomes 98