his wife had had enough “He keeps forgetting things.” He disagrees. Obviously. Late 70s. Hypertension. Previous TIA. CKD stage 3. No chest pain. No palpitations. No syncope. BP 146/84. SpO₂ 98%. He looks annoyingly well. You do an ECG. It doesn’t look particularly impressed by the situation either. Your move. 1. What’s the diagnosis? 2. What TWO ECG features prove it? 3. What would you do next? 4. What’s the risk here? #ecg #ecgdecoded #ekg #ekginterpretation #EKGtraining

A man in his late 60s comes in because he’s been feeling a little light-headed when he gets up in the morning. No syncope. No chest pain. No breathlessness. By the time you see him, he feels completely fine. Observations are reassuring, but you decide to get an ECG anyway. Here it is. What’s your diagnosis? Your move. #ecg #ekg #ecginterpretation #cardiology #medical education

He’s pale. Cold. Pulse barely there. Heart rate? 27. Your colleague says, “But the P waves are there!” Exactly. The P waves are there. The ventricles just aren’t listening. This is complete heart block. Look closely. Two rhythms living inside one heart. The atria march along at their own rate. The ventricles crawl along independently. No relationship. No consistent PR interval. No communication. That’s AV dissociation. How do you recognise complete heart block? 1. P waves present and regular. 2. QRS complexes regular but much slower. 3. Atrial rate > ventricular rate. 4. P waves and QRS complexes have no fixed relationship. This isn’t Mobitz I. This isn’t Mobitz II. This is divorce. The atria and ventricles have gone their separate ways. And that ventricular escape rhythm? It’s the backup system keeping this patient alive. In an unstable patient with profound bradycardia, this is not an ECG to admire for five minutes. Get resuscitation support and prepare for urgent pacing while treating reversible causes. The goal isn’t to memorise another ECG. It’s to look at something like this and know, almost instinctively, what you’re seeing, why it’s happening and what comes next. If that’s how you want ECGs to feel, type CONFIDENCE. I’ll show you the framework we use to get there. #ecg #ecgdecoded #cardiology #emergencymedicine #medicaleducation

No textbook. No carefully manufactured exam question. A sad looking middle aged person presented for medical assessment, and this ECG was recorded. Chest pain for a while now, they said. Someone passes you the strip to sign and says “this looks odd, innit?” The patient is awake. Talking. What do you see? 1. What is the diagnosis? 2. Which leads give it away? 3. Where is the culprit likely to be? 4. What are you doing next? And when? Because the ECGs we learn for exams eventually stop being exam questions. One day, there’s a real person sitting in front of you. #ecg #ecgdecoded #medicaleducation #emergencymedicine #cardiology

Middle-aged man. Severe chest pain radiating to the jaw. BP dropping. Monitor beeping. The ECG prints… and everyone thinks it’s just an inferior STEMI. But this one’s smarter. what else do YOU see on this ECG? #ecg #ecgdecoded #emergencymedicine #cardiology #medicaleducation