ECG

A 66-year-old with fever and hypotension on the medical ward.

A 24-year-old rower at a pre-participation physical. Asymptomatic.

A 19-year-old medical student practising on their own tracing.

A 74-year-old with palpitations and breathlessness since this morning.

A 68-year-old with COPD, 'regular palpitations' at exactly 150.

An 'irregular rhythm, query AF' referral; the baseline between the QRS complexes repays a second look.

An 81-year-old on three AV-nodal agents, brought in after a fall.

A 70-year-old on diltiazem and digoxin, dizzy on the ward.

A 29-year-old with abrupt-onset palpitations and lightheadedness.

A 63-year-old with a prior anterior infarct, palpitations, and a BP of 92/60.

Thirty minutes after primary PCI for inferior STEMI, a wide rhythm appears. BP 122/74.

An 81-year-old with syncope on the stairs.

An 84-year-old with presyncope on the stairs; a strip full of unconducted P waves.

A 77-year-old with unexplained syncope. The ECG is 'only showing blocks'.

A 61-year-old with one hour of crushing chest pressure and nausea.

A 54-year-old smoker, 40 minutes of chest pain, pale and sweating.

A pre-operative ECG in a 71-year-old who 'has never had heart trouble'. The inferior leads disagree.

A 61-year-old smoker with an hour of crushing chest pain radiating to the left arm.

A 58-year-old whose chest pain resolved in the ambulance. He feels fine and wants to go home.

A 79-year-old with sepsis, a hemoglobin of 68, and new chest tightness.

Ongoing chest pain, and 'only ST depression' in V1 to V3.

The 58-year-old from the lab module: weakness, potassium 7.1.

The vomiting patient from the alkalosis case: potassium 2.9.

Perioral tingling and carpopedal spasm two days after a total thyroidectomy.

Dialysis missed twice. Potassium 8.1. The QRS is stretching before your eyes.

Confusion, constipation, and a calcium of 3.4 in a patient with myeloma.

A 44-year-old on methadone, ondansetron, and now ciprofloxacin. Routine ECG before discharge.

A 28-year-old with sharp chest pain that eases when leaning forward, one week after a viral illness.

A 61-year-old with metastatic breast cancer, progressively breathless, with a strangely 'quiet' ECG.

A 59-year-old with years of untreated hypertension.

Decades of untreated hypertension; the clinic ECG prompts a phone call about 'possible ischemia'.

A 6-day-old, feeding well, examined for a soft murmur. The ECG is part of the work-up.

A 5-month-old with bronchiolitis, day 3, temperature 38.6, breathing at 58 with retractions. The nurse asks whether the heart rate of 172 is 'an SVT'.

A 3-month-old brought in because she 'will not feed and looks grey'. She has been irritable for a day. Rate 244, fixed, whatever anyone does.

A 15-year-old who collapsed during a swimming race, with a brief jerking episode witnessed by the coach. A cousin died suddenly at 19.

A newborn, day 2, whose mother has systemic lupus with anti-Ro antibodies. The fetal heart rate had been 'slow' on the last two scans. He is pink and feeding.

A 7-year-old, two weeks after a viral illness, with abdominal pain, vomiting and tiredness. He is pale, cool, and his liver edge is 3 cm below the ribs. The ECG was ordered because 'the heart rate would not come down'.