ICU ECG practice
All ECG Cases
Diagnosis choice + why choice. No free-text interpretation. Case titles do not reveal the answer before you open them.
ECG diagnosis challenge
Routine ICU admission ECG in a hemodynamically stable adult.
ECG diagnosis challenge
Fever and pain with a regular pulse around 125/min.
ECG diagnosis challenge
Sedated ICU patient with a regular pulse around 48/min and preserved blood pressure.
ECG diagnosis challenge
The monitor alarms for a very fast rhythm while the patient is awake, speaking, and has a palpable regular pulse.
ECG diagnosis challenge
A shivering patient has a noisy ECG but a stable pulse and normal arterial waveform.
ECG diagnosis challenge
Pre-procedure ECG in a stable adult with no cardiopulmonary symptoms.
ECG diagnosis challenge
Hypovolemia with a regular narrow-complex rhythm around 115/min.
ECG diagnosis challenge
Postoperative patient with a regular narrow-complex rhythm around 52/min.
ECG diagnosis challenge
During transport, the tracing becomes chaotic while pulse oximetry and arterial pressure remain regular.
ECG diagnosis challenge
Rigors produce rapid baseline oscillation across limb leads, but QRS complexes continue at a normal rate.
ECG diagnosis challenge
New rapid irregular pulse in a septic ICU patient.
ECG diagnosis challenge
Regular narrow-complex tachycardia near 150/min with repetitive atrial activity.
ECG diagnosis challenge
Abrupt onset palpitations with a regular narrow-complex rhythm near 180/min.
ECG diagnosis challenge
Regular narrow-complex tachycardia with abnormal but consistent atrial activity before each QRS.
ECG diagnosis challenge
COPD exacerbation with an irregular narrow-complex tachycardia.
ECG diagnosis challenge
Hypotension with a regular broad-complex tachycardia.
ECG diagnosis challenge
Syncope with a rapid broad-complex rhythm whose morphology changes beat to beat.
ECG diagnosis challenge
Marked QT prolongation followed by recurrent syncope and polymorphic ventricular tachycardia.
ECG diagnosis challenge
Unresponsive pulseless patient with chaotic electrical activity.
ECG diagnosis challenge
Irregular tachycardia around 150/min in a critically ill patient.
ECG diagnosis challenge
Regular narrow-complex bradycardia with visible atrial activity before each QRS.
ECG diagnosis challenge
Regular narrow-complex rhythm around 45/min with no clear sinus P wave before the QRS.
ECG diagnosis challenge
Every atrial impulse conducts, but the PR interval is clearly prolonged.
ECG diagnosis challenge
Grouped beating with progressive PR prolongation before a dropped QRS.
ECG diagnosis challenge
Intermittent non-conducted P waves occur without progressive PR prolongation.
ECG diagnosis challenge
Slow ventricular rhythm with atrial activity marching independently.
ECG diagnosis challenge
Regular narrow-QRS escape rhythm near 50/min with retrograde atrial activity after some QRS complexes.
ECG diagnosis challenge
A stable PR interval is seen on conducted beats with intermittent non-conducted P waves.
ECG diagnosis challenge
Acute ischemic chest discomfort with focal anterior ST elevation.
ECG diagnosis challenge
Acute chest discomfort with inferior territorial ST elevation.
ECG diagnosis challenge
Acute chest pain with focal lateral ST elevation.
ECG diagnosis challenge
Acute ischemic symptoms with marked ST elevation from V2 through V5.
ECG diagnosis challenge
Acute chest pain with ST elevation maximal in III and aVF and reciprocal depression in aVL.
ECG diagnosis challenge
Renal failure with new tall symmetric T waves and a still-narrow QRS.
ECG diagnosis challenge
Dialysis-dependent patient develops progressive conduction slowing, loss of atrial activity, and broadening QRS complexes.
ECG diagnosis challenge
Large gastrointestinal losses are followed by weakness and new ventricular ectopy.
ECG diagnosis challenge
An oncology patient develops a visibly shortened ventricular repolarization interval.
ECG diagnosis challenge
A postoperative patient with paresthesias develops clearly prolonged ventricular repolarization.
ECG diagnosis challenge
An exposed patient is profoundly cold, bradycardic, and has prominent J-point notching.
ECG diagnosis challenge
A dialysis patient develops absent P waves, marked QRS widening, and very tall T waves.
ECG diagnosis challenge
After intensive diuresis, a patient develops weakness and new ventricular ectopy.
ECG diagnosis challenge
A hypotensive patient after an unknown cardiovascular medication ingestion has marked sinus bradycardia and AV-nodal slowing.
ECG diagnosis challenge
A patient in shock after an unknown cardiovascular medication ingestion has a slow junctional/AV-nodal rhythm.
ECG diagnosis challenge
After several new ICU medications, the ECG shows a markedly prolonged QT interval in a patient with low magnesium.
ECG diagnosis challenge
Sudden dyspnea and tachycardia after surgery.
ECG diagnosis challenge
Regular broad QRS complexes are consistently preceded by pacing spikes.
ECG diagnosis challenge
Pacing artifacts precede atrial and ventricular depolarization in a patient with a permanent pacemaker.