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10 High-Risk ECG Patterns Requiring Urgent Intervention 1. Wellens – LAD critical stenosis 2. Brugada – VF risk 3. Hyperkalemia – Sine-wave evolution 4. Massive PE – S1Q3T3, RBBB 5. STEMI – Contiguous ST↑ 6. LM/prox LAD – ST↑aVR, diffuse ST↓ 7. VT – Treat as VT unless proven otherwise 8. TdP – Polymorphic VT long QT 9. 3° HB – AV dissociation, escape rhythm 10. Tamponade – Low voltage ± alternans Each pattern correlates with a time-sensitive clinical pathway. 📈 Review the diagnostic criteria ab
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1️⃣ Left Bundle Branch Block (LBBB) • ECG: Wide QRS complex (>120 ms), broad or notched R wave in leads I, V5–V6 • Echo effect: • The interventricular septum contracts early • The left ventricular free wall contracts late • Result: Jerky or paradoxical septal motion • 👉 Most common cause ⸻ 2️⃣ Right ventricular pacing (pacemaker rhythm) • ECG: Pacing spikes with an LBBB-like QRS morphology • Echo: • Abnormal electrical activation leading to septal dyssynchrony • Jerky septal motion is commonly
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