ECG CHALLENGE PART 2

Course overview

Hospital Emergency Departments receive over five million patients a year who complain of chest pain. The amount of litigation, patient injuries, and dollars paid in cases involving the failure to diagnose acute myocardial infarction (MI) is staggering. The majority of adverse outcomes in chest pain cases result from failure to identify critical historical factors and/or failure to correctly evaluate one or a series of electrocardiograms (ECGs). According to the medical literature, up to 25% of all missed acute MI patients would have been diagnosed and/or admitted if the physician had recognized obvious ischemic ECG changes or a significant change in the ECG over time. Practitioners should be experts in ECG evaluation and should be able to identify both obvious and subtle changes of ischemic heart disease. In this activity, we focus on the interpretation of ECGs and highlight the subtle findings that may aid in the diagnosis of MI; discuss wide complex tachycardias; talk about arrhythmias with a concentration on rhythms that are frequently misinterpreted; and examine the use of ECG as a tool to assist in the diagnosis of pseudo-infarctions, specifically pulmonary embolism (PE). After completing this activity, practitioners should be able to: identify subtle signs of ischemia caused by acute MI or acute coronary syndrome on ECGs for patients presenting with chest pain; distinguish between ventricular tachycardia and supraventricular tachycardia on ECGs for patients presenting with rapid heart rate arrhythmias; and use the ECG as a tool to distinguish between and assist in the diagnosis of acute MI, PE and other conditions.