Our goal is to make ECG interpretation simple, practical, and fun for acute providers; and we believe that mastery of this simple skill will save lives.
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You see repeating clumps of two beats.
The rhythm is regularly irregular.
What’s the best next step? 🔎
9%
Diagnose AF
82%
Map the P waves
0%
Ignore the pattern
9%
Look only at Lead II
11 votes • 1 day
241
The computer sees irregularity and calls AF. But irregular isn’t enough. 👀
AF should be irregularly irregular. A repeating pattern should make you look harder.
So what’s actually causing the irregularity?
ecgweekly.com/weekly-workout…
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A 61-year-old man presents with severe chest pain. His initial 12-lead ECG shows poor R wave progression, but no obvious ST elevation or depression. The computer interprets it as normal......ecgweekly.com/weekly-workout…
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1,749
Don’t let a “classic” ECG finding override the patient. ⚠️
S1Q3T3 may reflect right-heart strain, but by itself it does not establish PE.
Interpret the tracing in context.
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817
Don’t let a “classic” ECG finding override the patient.
S1Q3T3 may reflect right-heart strain, but by itself it does not establish PE.
Interpret the tracing in context.
3
724
How sensitive is S1Q3T3 for pulmonary embolism according to the data discussed by Dr. Mattu? 🫁
4%
90%
6%
~75%
17%
~50%
74%
<15%
54 votes • Final results
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2
860
S1Q3T3 is memorable—but “classic” doesn’t mean diagnostic. 🫁
It’s neither sensitive nor specific for PE prospectively.
Clinical context matters.
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883
S1Q3T3 = PE? 🤔
It’s one of medicine’s most recognizable ECG associations—but how much weight should it carry when the clinical picture doesn’t fit?
What does S1Q3T3 actually tell you?
ecgweekly.com/weekly-workout…
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A 37-year-old patient presents with abrupt onset of palpitations and marked tachycardia. The blood pressure is relatively preserved, and the following 12-lead ECG is obtained......ecgweekly.com/weekly-workout…
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6,344
Don't let one rhythm strip make the diagnosis.
Lead II may hide atrial activity that becomes obvious elsewhere—often V1, and occasionally another lead entirely.
Rhythm interpretation is a 12-lead exercise.
1
884
The computer calls sinus tachycardia. Lead II isn’t convincing.
Which lead may make hidden atrial activity much more obvious? 🔎
3%
Lead I
0%
Lead III
9%
aVL
88%
V1
34 votes • Final results
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1
904
TRUE OR FALSE? 👀
If Lead II doesn’t show clear P waves, you can assume the rhythm isn’t sinus.
What’s your call? 👇
27%
TRUE
73%
FALSE
45 votes • Final results
1
982
The ECG machine calls atrial flutter, and Lead II seems to agree. But Dr. Mattu checks his “money lead”: V1.
Sometimes the rhythm you think you see isn't really there.
What does V1 reveal?
ecgweekly.com/weekly-workout…
ecgweekly.com/weekly-workout…
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1,029
A 70 yo man presents with exertional weakness. His blood pressure is adequate at rest, and he appears comfortable while lying on the stretcher. Bradycardia prompts a 12-lead ECG, which the computer interprets as sinus......ecgweekly.com/weekly-workout…
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1,777
63-year-old with SOB and beats in pairs.
Grouped beats usually suggest Mobitz or PACs—but this tracing fits neither.
There’s another, less familiar rhythm pattern in the differential.
Can you name it?
Full case → ecgweekly.com/weekly-workout…
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1,014
Polymorphic VT ⚡
Before deciding what’s driving it, what should you check next on the ECG? Cast your vote 👇
58%
QTc in the intrinsic beat
42%
QRS axis during the VT
31 votes • Final results
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🚨 Nonsustained monomorphic VT shows up on the monitor. What’s your first-line treatment?
57%
Amiodarone
43%
Beta blocker
49 votes • Final results
2
810
