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ECG Case: Polymorphic Ventricular Tachycardia

Amal Mattu

Watch the video to see what do you have to look for in an ECG of a patient with syncope. Find out why this young patient lost his consciousness. How to treat polymorphic VT?

views: 2082 comments: 0

ECG Case: CNS disease

Amal Mattu

ECG findings in patients with elevated intracranial pressure: Diffuse T-wave enlargement and inversions Brady- and tachydysrhythmias Non-specific ST changes ST changes mimicking ischemia

views: 2498 comments: 1

ECG Case: Regular Wide Complex Tachycardia

Amal Mattu

Your first thought is VT? Look how wide are those QRS complexes. In case of such wide complexes you should first think of toxicologic and metabolic causes (hyperkalemia & severe acidosis)

views: 825 comments: 0

ECG Case: MI in Paced Rhythm

Amal Mattu

It possible to diagnose MI in paced rhythms, you just need to use Sgarbossa’s criteria: 1. STE ≥ 1mm concordant with QRS deflection in any single lead 2. STD ≥ 1mm in V1, V2, OR V3 that is concordant....

views: 2542 comments: 0

ECG Case: Pulmonary Embolism

Amal Mattu

ECG findings in Pulmonary Embolism: -Sinus Tachycardia (only 30-50%) -SIQIII or SIQIIITIII , a.k.a. Rightward Axis (not sensitive or specific) -New RBBB or incomplete RBBB -Superventricular...

views: 2427 comments: 1

ECG Case: Wide Complex Tachycardia

Amal Mattu

Differential for regular wide complex tachycardia Ventricular Tachycardia!!!!! - this should be always your first suspicion SVT, atrial flutter or sinur tachycardia with aberrant conduction Look...

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ECG Case: WPW Syndrome

Amal Mattu

WPW triad Short PR interval Widened QRS (>120ms) Delta wave (but: not always present!)​

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ECG Case: Deformed T-waves

Amal Mattu

Always look for P-waves. They might be buried in T-waves or QRS complexes. Their presence and correlation with QRS complexes is important in differential diagnosis of brady- and tachyarythmias.

views: 2091 comments: 0

ECG Case: Complete Heart Block

Amal Mattu

Look carefully for the P-waves or you will miss the proper diagnosis! Little blimbs that you see in lead II are regular - those are the P waves. There is no relation between them and QRS complexes which...

views: 2138 comments: 0

Coronary Artery To Left Ventricle Fistula...

maged al ali

TTE parasternal long axis view with color doppler shows diastolic flow from the septum to the left ventricle. Video by Maged Al Ali MD.

views: 1700 comments: 0

Coronary Artery To Left Ventricle Fistula...

maged al ali

TTE parasternal short axis view with color doppler shows diastolic flow from the septum to the left ventricle. Video by Maged Al Ali MD.

views: 1540 comments: 0

Coronary Artery To Left Ventricle Fistula...

maged al ali

TTE modified four chamber view with color doppler shows diastolic flow from the septum to the left ventricle. Video by Maged Al Ali MD.

views: 1234 comments: 0

Coronary Artery To Left Ventricle Fistula...

maged al ali

TTE color M-mode shows diastolic flow from the septum to the left ventricle. Video by Maged Al Ali MD.

views: 1342 comments: 0

Mitral Stenosis In Different Aspects: Left...

maged al ali

TEE shows left atrial spontaneous contrast and a left atrial appendage thrombus in a case of mitral stenosis in atrial fibrillation. Video by Maged Al Ali MD.

views: 2123 comments: 0

Mitral Stenosis In Different Aspects: LA...

maged al ali

TEE shows spontaneous contrast in the left atrium and the left atrial appendage in a case of mitral stenosis in atrial fibrillation. Video by Maged Al Ali MD

views: 1638 comments: 0

ECG Case: STEMI vs. Benign early repolarization...

Amal Mattu

Differential diagnosis for diffuse STE Large STEMI Pericarditis Early repolarization Ventricular aneurysm LBBB LVH Brugada syndrome Hyperkalemia To make a good diagnosis check:...

views: 4438 comments: 0

ECG Case: Inferior STEMI. What is the rhythm?

Amal Mattu

What we see in this ECG is a ST segment elevation in inferior leads which means inferior MI. In those patients always consider right ventricular and posterior MI. The computer called this sinus bradycardia....

views: 2965 comments: 0

Tumor-like Calcification Of The Mitral Annulus

maged al ali

Various echocardiographic views show tumor-resembling calcifications of the mitral annulus. Video by Maged Al Ali MD.

views: 2071 comments: 0

Left Ventricular Noncompaction

maged al ali

Left ventricular noncompaction or "spongy myocardium" is a rare congenital cardiomyopathy that can be diagnosed at any age. It is characterised by a thin, compacted epicardial layer and an extensive...

views: 3196 comments: 0

ECG Case: A normal variant - not Wellens...

Amal Mattu

There is a normal variant pattern, seen in young males, mostly African-Americans Look for fishhooked J-points, concave upward STE before a steep T-wave drop

views: 967 comments: 0

ECG Case: Wellens Syndrome

Amal Mattu

T-wave abnormality in precordial leads (most specific in V2-V3, but can be also present in V4) -Type 1-deeply symmetric T-wave inversion -Type 2- biphasic T waves with terminal T-wave inversion...

views: 3231 comments: 0

Atrial Septal Aneurysm With Chaotic Movement...

maged al ali

Echocardiographic subcostal view shows atrial septal aneurysm and chaotic movement of the interatrial septum in a baby. Video by Maged Al Ali MD.

views: 1574 comments: 0

Atrial Septal Aneurysm With Chaotic Movement...

maged al ali

Echocardiographic apical four-chamber view shows atrial septal aneurysm with chaotic movement of the interatrial septum in a baby. Video by Maged Al Ali MD.

views: 2233 comments: 0

Sub Aortic VSD (2)

narendra chaudhari

Same case sort axis view at aortic level defect at 9 oclock position.

views: 1244 comments: 0

Sub Aortic VSD (1)

narendra chaudhari

21 year old lady c/o recurrent rti no complaints, loud systolic murmur at 3 rd intercostal space ekg -right axis deviation and rvh no other positive finding echo shows sub aortic vsd with 50 % over ridding...

views: 1387 comments: 0

ECG Case: Evolving T-wave changes

Amal Mattu

If you have concerns of an ECG - get serial ECGs! T-wave changes can predict cardiac ischemia Wellens syndrome - Biphasic T-wave pattern in precordial leads can be specific for proximal LAD lesions

views: 2480 comments: 0

ECG Case: Brugada Syndrome

Amal Mattu

ECG Findings in V1-V3 -RBBB or Incomplete RBBB -Coved or Saddle type ST-segment elevation It is important not to miss this condition. Patients with Brugada syndrome can develope fast polymorphic...

views: 2611 comments: 0

ECG Case: The diagnosis of MI in LBBB &...

Amal Mattu

Sgarbossa’s criteria is used to diagnose MI in the setting of LBBB or paced rhythms. 1. STE ≥ 1mm concordant with QRS in any lead 2. STD ≥ 1mm in V1, V2, or V3 that is concordant. 3. Discordant STE...

views: 2568 comments: 1

Multiple Rhabdomyomas In Patient With Tuberous...

maged al ali

Echocardiographic parasternal long axis view shows rhabdomyomas in a 3 month-old girl with tuberous sclerosis. There are multiple locations of the tumors: left ventricle, left ventricular outflow tract...

views: 1201 comments: 0

ECG Case: Irregular Narrow-Complex Tachycardia

Amal Mattu

Differential diagnosis for Irregular Narrow-Complex Tachycardia -Atrial Fibrillation No clear atrial activity -Atrial flutter with variable conduction Regular atrial activity around...

views: 1668 comments: 0

ECG Case: Is it really Atrial Fibrillation?

Amal Mattu

If the rythm is regularly irregular it is not AF! Look for P-waves! What can it be? -Premature Atrial Complexes (groups of 2 -> atrial bigeminy, groups of 3 -> atrial trigeminy) -2nd Degree...

views: 2473 comments: 0

ECG Case: Hyperkalemia & Bradycardia

Amal Mattu

ECG findings in Hyperkalemia -Peaked T-waves -Widening of the QRS -Prolonged PR -Flattening of P-waves -Advanced AV Blocks and sinus pauses ​-Pseudo ACS, new BBB’s, ST-segment...

views: 5254 comments: 0

ECG Case: Short QT interval

Amal Mattu

Causes of short QT-Interval -Digoxin Toxicity -Hypercalcemia -Congenital syndrome

views: 1546 comments: 0

ECG Case: Prolonged QT-interval

Amal Mattu

Differential diagnosis for prolonged QT-interval: -Hypothermia -Hypokalemia (due to U-wave), Hypomagnesemia, & Hypocalemia -Acute coronary syndromes -Increased intracranial pressures...

views: 1941 comments: 1

Endocarditis - Vegetation On The Pacemaker...

maged al ali

TEE shows a vegetation on the pacemaker lead and the anterior leaflet of the tricuspid valve. Video by Maged Al Ali MD.

views: 2260 comments: 0

Infective Endocarditis

maged al ali

TEE shows the vegetations and chordal rupture of both leaflets of the mitral valve with massive mitral regurgitation. Video by Maged Al Ali MD.

views: 1824 comments: 2

ECG Case: STEMI in Young Patient

Amal Mattu

​Differential diagnosis for ST-segment elevation: ​ -Large STEMI -Early repolarization ​​​ -Pericarditis -Myocarditis ​ -Ventricular aneurysm -LBBB -LVH -Brugada syndrome Early repolarization...

views: 2596 comments: 0

ECG Case: Patient with Chest Pain

Amal Mattu

All fatal causes of chest pain should be ruled out: -Acute Coronary Syndrome -Aortic Dissection -Pulmonary Embolism -Pericarditis/Tamponade -Tension Pneumothorax -Esophageal rupture Remember:...

views: 1654 comments: 0

ECG Case: Ischemic T-waves

Amal Mattu

Straightening of the initial upslope of the T-wave is a sign of early ischemia. Repeat ECG and look for the new changes to confirm the diagnosis. Watch the video to see the examples.

views: 919 comments: 0

Dissection Of The Ascending Aorta (2/2)

maged al ali

TEE shows aortic dissection type A involving one of the aortic cusps what may cause coronary malperfusion. Video by Maged Al Ali MD.

views: 1499 comments: 0

Dissection Of The Ascending Aorta (1/2)

maged al ali

TEE color doppler shows aortic dissection type A involving one of the aortic cusps. Video by Maged Al Ali MD.

views: 1603 comments: 0

ECG Case: Atrial Fibrillation with WPW

Amal Mattu

Characteristic ECG appearance of AF with WPW: -very rapid (even up to 300 bpm) -very irregular -changing QRS morphologies When misdiagnosed and threated with AV nodal blockers (like beta blockers...

views: 4098 comments: 1

ECG Case: WPW syndrome

Amal Mattu

Characteristic signs of pre-excitation syndrome in ECG: -Short PR interval -QRS more than 120ms -Delta wave Patients with this syndrome can suffer from 2 kinds of SVT: -Orthodromic SVT - conduction...

views: 1590 comments: 0

Multiple Apical Ventricular Septal Defects...

maged al ali

TTE four chamber view shows multiple apical ventricular septal defects. Video by Maged Al Ali MD.

views: 1058 comments: 0

Multiple Apical Ventricular Septal Defects...

maged al ali

TTE parasternal long axis view shows multiple apical ventricular septal defects. Video by Maged Al Ali MD.

views: 699 comments: 0

ECG Case: ST-elevation in aVR

Amal Mattu

Each time you see signs of ischemia in ECG look at aVR. If there is a ST-segment elevation there it signifies one of three serious conditions: -LMCA occlusion -proximalal LAD occlusion -triple vessel...

views: 3210 comments: 0

ECG Case: Pericardial Effusion

Amal Mattu

If you see in an ECG: -tachycardia -low voltage (QRS in leads I+II+III is less than 15mm) -electrical alternans (consecutive QRS complexes alternate in height) ...always consider pericardial effusion,...

views: 1220 comments: 0

Apical Ventricular Septal Defect

maged al ali

Echocardiographic four chamber view shows apical ventricular septal defect. Video by Maged Al Ali MD.

views: 1239 comments: 0

Hydatid Cyst In The Interventricular Septum...

maged al ali

Echocardiographic parasternal long axis view shows a very rare localization of hydatid cyst - intraventricular septum. Video by Maged Al Ali MD.

views: 1448 comments: 0

ECG Case: New T-wave inversion in aVL

Amal Mattu

Lead aVL can show early reciprocal changes from an myocardial infarction before ST-elevation in inferior wall leads. New T-wave inversion in this lead should call our attention. Inverted T-wave in aVL...

views: 2511 comments: 0