1. © M. FRANCE DOYLE, MD, FACEP ECGs for Students

2. ECG #1 The ECG tech shows you this ECG from a 68 year-old male patient in Triage. He doesn’t know anything about the patient. “I think he has some chest pain, or maybe some shortness of breath. Should the nurse put him in the Resus Room?”

3. #1

4. ECG #2 Janis J., a 27 year-old singer, is dropped off at the ER by her friends, who state that she has been partying hard, shooting amphetamines and heroin, while drinking large amounts of alcohol, for the past several days. They report that she was complaining of chest pain and trouble breathing before she passed out. She is awake now, and is mumbling about some chest pressure. “Please, Doc, I don’t want to join the 27 Club. You gotta help me!” The charge nurse puts her in MEC 13, and the ECG tech shows you this ECG.

5. #2

6. ECG #3 Bill C., a 62 year-old retired politician, arrives at the ER with his coterie of Secret Service agents, and is complaining of indigestion. He’s had several episodes of heartburn recently, and has also noticed that his running times have increased lately – the 8- minute mile has become the 10-minute mile on his thrice weekly jogs.

7. #3

8. ECG #4 Martin B., a 39 year-old male, is brought in by EMS. He was found down on Central with head lacerations. He is in MEC 12. The ECG from Triage is on the chart.

9. #4

10. ECG #5 Corazon de Cantimplora, a 60 year-old female, presents with a 4 day history of increasing shortness of breath with exertion. She is sitting in room 31, and appears to be perspiring a bit. She is currently on chemo for metastatic breast cancer.

11. #5

12. ECG #6 He Su Yu, a 47 year-old male attorney, is brought to the ER by EMS after a witnessed v-fib arrest at home. His wife was awakened at 0200 hrs because he was thrashing about. He then stopped breathing. She immediately began CPR and called 911. The paramedics arrived at 0209, and found v-fib on the monitor. They shocked him 3 times, gave epi and amiodarone, placed a Combitube and transported him to the ER. Thanks to Jenny Hall, MD!

13. #6

14. ECG #7 Rudy G., an 87 year-old man in a short-leg walking cast, is complaining of episodes of palpitations and shortness of breath.

15. #7

16. ECG #8 Carl Jr., the 59 year-old proprietor of a local fast food restaurant, is complaining of heartburn after an arduous stint as judge of the annual NM Chili Cook- off. The pain is located in the epigastrum and radiates to the RUQ and the neck.

17. #8

18. ECG #9 Sister Perpetua Immaculata, a 26 year-old Catholic nun, comes to the ER on Sunday morning. She was at church when she began to experience a strange fluttering in her chest. At first she thought it was the Holy Spirit, but then she broke out in a sweat, vomited, and nearly fainted. Her symptoms resolved before the paramedics arrived. Upon further questioning, Sister Perpetua Immaculata says that she has had a fever for the last 3 days, and has been taking penicillin for a sore throat.

19. Sister Perpetua Immaculata

20. #9

21. ECG #10 Ron H., a 72 year-old Christmas tree farmer, presents to the ER on Thanksgiving morning, complaining that he is more tired than usual. It’s the busiest time of the year for him, and he couldn’t find time to see his own doctor, so he came to the ER (ha ha ha).

22. #10