Explain me 10 common heart disease with there characteristic ECG changes and illustrative ECG images
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STEMI ST elevation myocardial infarction ECG 12 lead
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ventricular tachycardia ECG wide complex rhythm strip
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Wolff-Parkinson-White WPW delta wave ECG short PR
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pericarditis diffuse ST elevation saddle shaped ECG
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pulmonary embolism ECG S1Q3T3 right heart strain
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left bundle branch block LBBB ECG QRS morphology
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hypertrophic cardiomyopathy HCM ECG left ventricular hypertrophy deep Q waves
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atrial flutter sawtooth P waves ECG flutter waves
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long QT syndrome QT prolongation ECG torsades de pointes
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ventricular fibrillation ECG chaotic waveforms cardiac arrest
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This guide covers the 10 most clinically important heart diseases with their characteristic ECG patterns, backed by authoritative textbooks and illustrated with real ECG tracings from the medical literature. Here are a few key teaching points worth remembering:
Critical differentiators:
- STEMI vs Pericarditis: Pericarditis has diffuse saddle-shaped ST elevation with PR depression but no reciprocal ST depression (except aVR/V1). STEMI has focal convex ST elevation with reciprocal depression.
- VT vs SVT with aberrancy: Favour VT if QRS >160 ms, northwest axis, AV dissociation, or fusion/capture beats are present. When in doubt, always treat as VT.
- WPW + AF: Never give AV nodal blockers (adenosine, verapamil, digoxin) — they can accelerate accessory pathway conduction, leading to VF.
- New LBBB: Always consider acute MI (Sgarbossa criteria); new LBBB in the right clinical context should be treated as STEMI equivalent.
- QTc >500 ms: Substantially increases risk of torsades de pointes; review and remove offending drugs, correct electrolytes (K⁺, Mg²⁺).
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