CREIGHTON/MARICOPA EMERGENCY MEDICINE RESIDENCY
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A walk through Syncope

8/23/2016

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This week take a chance to walk step by step through an initially complex appearing EKG.  Dr. Mattu shows how a step by step approach, stopping at each abnormality found to analyze the differential.  A reminder of his systematic approach: Click the Read More link to see some of the diferentials discussed this week.
  1. Rate and rhythm
  2. Axis
  3. Intervals
  4. Enlargement
  5. Ischemia/infarction
Copa Cardiogram #58
DDx:
Leftward Axis
  • LBBB
  • Pacer
  • WPW
  • Inferior MI (from Q waves)
  • LAFB
  • LVH
  • Hyper K
  • Normal Variant
DDx:
Wide QRS
  • BBB (LBBB, RBBB)
  • Pacer
  • WPW
  • Ventricular ectopy
  • Metabolic (acidosis, hyperK)
  • Sodium channel blockers
  • Non Specific Interventricular Conduction Delay (eg LVH)
DDx: 
T Wave Inversions
  • CAD (acute or chronic)
  • Abnormal repolarization
    • LBBB, pacers, RBBB, LVH, RVH
  • WPW
  • Pulmonary disease
    • PE, PHTN (acute or chronic), hyperventilation
  • CNS events
  • Hyperkalemia
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    Author

    Our thanks to Dr. Tim Davie for assembling the Copa Cardiogram each week.  Please follow this link to get to spreadsheet of all Copa Cardiograms.

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Department of Emergency Medicine
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  • Home
  • Program
    • Program Director's Message
    • Benefits
    • Clinical Sites >
      • Valleywise Health
      • Arizona Burn Center
      • Phoenix Children's Hospital
      • Banner University Medical Center – Phoenix
      • Toxicology - BUMCP
      • Mayo Clinic Arizona
      • Banner Cardon Children's Medical Center
    • Curriculum >
      • Curriculum
      • Electives
    • Diversity + Inclusion
    • Faculty >
      • Department Chair
      • Faculty Bios
      • Faculty Alumni
      • Program Coordinators
    • Residents >
      • Class of 2021
      • Class of 2022
      • Class of 2023
      • Alumni
    • Students >
      • Adult EM Rotation
      • Ultrasound Rotation
      • Applying to Rotate
      • Applying to the Program
      • Interviews
    • Research
    • Vision & Principles
    • Ultrasound >
      • Ultrasound Director
      • Ultrasound Fellowship
      • Education (internal link)
      • Admin (internal link)
    • Admin Fellowship