Quiz Master: Self-Assessment of Clinical ECG Skills


Questions

This online section, designed for additional skill mastery, includes 50 ECG cases, grouped thematically. They are of varying levels of difficulty, ranging from entry level to much more challenging. Good luck! This part is self-scored. Working in small groups may be helpful.

Life-Savers: Stat ECG Diagnoses

The following five patients all have different life-threatening problems that you can diagnose from their electrocardiograms ECGs without any further history.

Case 1, A 60-year-old man

Case 2, A 50-year-old man

Case 3, A 68-year-old man

Case 4, A 75-year-old woman

Case 5, A 52-year-old man

Triage Tryout

Two patients arrive in your clinic office at the same time. Both complain of severe chest discomfort. Only one ambulance and one taxicab are available for transporting them to the nearest hospital, which is 15 miles away. Who gets the taxi, and who gets the ambulance?

Case 6, A 50-year-old man with chest pain

Case 7, A 50-year-old man with chest pain

Four Cases of Mistaken Identity

The following ECGs are incorrectly identified as shown. For each mistakenly interpreted ECG, what is your correct diagnosis?

Case 8, “Left bundle branch block or left ventricular hypertrophy with inferior myocardial infarction”

Case 9, “Complete heart block”

Case 10, “Sinus (or ectopic atrial) tachycardia”

Case 11, “Right axis deviation resulting from lateral wall infarction”

Syncopated Rhythms

Both of these patients are complaining of palpitations, characterized as an “irregular heartbeat sensation.” What are the diagnoses?

Case 12

Case 13

Incomplete Diagnoses of Complete Right Bundle Branch Block

Right bundle branch block was correctly diagnosed in these two patients with chest pain. That finding is only part of the story, however. What else is going on?

Case 14

Case 15

Morphing P Waves

What subtle arrhythmia is present in this ECG?

Case 16

Tearful Patient

Why is this healthy female crying? (Clue: Consider the QRS duration.)

Case 17

Tricky Business

An ECG is obtained in this 45-year-old man before he undergoes appendectomy. He complains of lower left quadrant pain. The ECG is unchanged from a previous one, at which time the work-up revealed normal cardiac function. What is the diagnosis?

Case 18

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