Is this Rhythm Puzzling to You?

==================================My Comment by KEN GRAUER, MD (3/30/2023):==================================The ECG in Figure-1 was sent to me without the benefit of any history. I thought the rhythm illustrated a number of essential concepts for clinicians dedicated to Emergency Care.Do YOU know what the rhythm is?IF this arrhythmia is puzzling to you — READ ON!  I illustrate how to make the diagnosis within less than 15 seconds.Figure-1: The initial ECG in today ' s case. This tracing was sent to me without the benefit of any history. (To improve visualization — I ' ve digitized the original ECG using PMcardio).MY Initial Thoughts on the ECG in Figure-1:As noted — I was sent today ' s ECG without the benefit of any history, other than knowing that the patient presented to the ED. My quick initial survey of this tracing revealed T wave inversion in lead aVL and some T waves that might be hyperacute (ie, in the inferior leads and in V1,V2,V3). That said, although this ECG is suspicious —I thought it was not at this point diagnostic of acute OMI. Clinically— Since this ECG is not at this point diagnostic — whether or not an acute cardiac event was in progress would appropriately be delayeduntil some history, a repeat ECG, and troponins could be obtained. In the meantime — I focused my attention on the " eye-catching " a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs