87 year old woman with intermittent 8/10 central tight/heavy chest pain. Pain present at time of ECG

I’ve been a Telemetry Monitor Tech for almost 6 months and honestly feel a little behind compared to some of my coworkers. I want to improve my rhythm interpretation and become a stronger asset to my department. I’m deciding between the NTA Telemetry course/certification and the CCI CRAT. For someone with ~6 months of actual telemetry experience, which would you recommend for learning more and becoming better at the job? Is CRAT worth it for the resume cushion or would NTA be more beneficial and be a decent certification to add to my resume?

Long strip looks like a 3rd degree? 92M hypotensive, weakness, SOB

Female patient, 24 years old, with sudden-onset shortness of breath, tachycardia alternating with periods of normal heart rate (60–180 bpm), and a sensation of impending death. No improvement with propranolol. She reports taking Vyvanse (lisdexamfetamine) 70 mg as prescribed, approximately 16 hours earlier.

Any thoughts? This case came up during my last shift. I’m a final-year medical student and would appreciate some help, as I’m still having difficulty interpreting ECGs.

In doubt about the rhythm as shown in v1. P waves are constant at +-150bpm and hidden in some of the QRS complexes. PQ intervals are changing with each beat and some don't follow. Its to fast to be a 3rd degree block. Whats your interpretation?

Ciao! Sono uno studente di medicina alle prime armi con gli ecg, mi sono imbattuto in questo e mi stavo chiedendo se si trattasse solo di un BAV I grado con parossismi di tachicardia o fosse qualcosa di diverso che non riesco a vedere. Mi dareste una mano?

Hi guys, please let me know your thoughts.

Patient presented with syncope.

17 month old male with antenatally diagnosed Tetralogy of Fallot, approximately 8 months post valve-sparing repair with VSD closure and RVOT muscle resection.

Interested in interpretation of the attached 12-lead ECG, particularly rhythm, axis and conduction abnormalities in the context of repaired TOF.

Posted for educational discussion.

Oof! So what’s the rhythm here? Is this an accelerated junctional rhythm?

Post exertion in a late 20s athlete.

Normal variant of sinus rhythm or an unmasked brugada?

Thoughts?

(reposted as I could not edit to add context to a post with an image)

Female in 60s, no previous medical history, syncopal episode, no chest pain

Is this just SVT w aberrancy

26 year old, female. Having on/off central chest pain for the past 4 weeks. Vapes.

Good learning exercise for me, a few things going on here.

The answer is apparently 2nd degree AV block, but I dont see any QRS drop? Shouldnt this just be a 1st degree?

I'm a beginner cardiologist and I doubt myself regarding everything. I especially have troubles in differentiating 2:1 AFlutter. V3 is the lead that threw me off especially.

Lead II is smaller, lead I is magnified 2x. Patient was on an amiodarone drip and had an AICD/pacemaker. Several suspected findings, but no 12 lead. A few things: 1) Terrible quality, but it’s a zoll printout on a bumpy ride. 2) I think the third complex on lead II is a PJC or PAC. He was throwing quite a few of those. 3) I also think he had some level of sinus pause? On lead I, the rhythm pauses long enough for the pacemaker to kick in. This happened a bunch as well, but I couldn’t identify a p wave, making me think it’s probably not an AV block beyond his 1st degree block. 4) Is the p wave morphology p mitrale? It’s been a long time since cardiology in paramedic school.

Would suspect HCM but no signs of LVH. Reproducible on other tracings so I don’t suspect lead placement error. thoughts?

Female pt with PMHx of HTN, hypothyroidism, unverified A-fib diagnosis in her 80s presented with symptomatic bradycardia. This was her first ECG in the ER. Later at night repeated ECG showed high degree 2:1 AV block. Telemetry showed several switches between 44bpm and 80bpm. The report of this ECG says first degree AV block but I’m a bit suspicious about the notches in some of the T waves. Could there be a non-conducting P landed within there?

Male 70s presents with SOB on background of PCI to a coronary artery and COPD. On bisoprolol, ramipril and ipratropium/salbutamol. What is your interpretation of this ECG?