Vegas Brown, MD – Emergency Medicine Physician

VEGAS BROWN, MD FAAEM FACEP

EKG Pearl: Hyperkalemia and Peaked T Waves

Pearl: One of the earliest EKG changes in hyperkalemia is tall, peaked T waves, especially prominent in the precordial leads (V2–V4). As potassium levels rise further, P waves may flatten, QRS complexes widen, and eventually sine-wave patterns can develop, leading to cardiac arrest.

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EKG Pearl: Wellens' Syndrome

Pearl: Wellens' Syndrome is a sign of critical stenosis of the left anterior descending (LAD) artery and indicates a high risk for an extensive anterior wall myocardial infarction. It is characterized by: Deeply inverted or biphasic T waves in leads V2 and V3 Minimal or no ST elevation Normal or slightly elevated cardiac enzymes

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EKG Pearl: Brugada Pattern

Pearl: Brugada Syndrome is associated with a risk of sudden cardiac death due to ventricular arrhythmias. The classic Type 1 Brugada pattern shows: Coved ST-segment elevation ≥2 mm in ≥1 of leads V1–V3 Followed by a negative T wave No structural heart disease

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EKG Pearl: Pericarditis

Pearl: Acute pericarditis classically progresses through four stages on the EKG: Stage 1: Diffuse ST elevation and PR depression (especially in leads I, II, V3–V6) Stage 2: Pseudo-normalization of the ST segments Stage 3: T wave inversion Stage 4: Resolution of EKG changes

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What is the antidote for acute tylenol toxicity?

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N-acetylcysteine

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