EM · The deadly ECG patterns

The deadly ECG patterns — the emergency department recognition and immediate management

Also known as Lethal ECG patterns · STEMI equivalents · Occlusion myocardial infarction · Brugada pattern · Sodium-channel-blocker cardiotoxicity

The emergency department ECG patterns that immediately change disposition or trigger an antidote — the STEMI territories (anterior, inferior, lateral, posterior, right ventricular), the STEMI-equivalents that represent an acutely occluded artery without meeting ST-elevation thresholds (de Winter T waves, Wellens syndrome, hyperacute T waves, Sgarbossa criteria in left bundle branch block and paced rhythm), the Brugada type-1 coved pattern, the hyperkalaemia progression from peaked T to sine wave, the markedly prolonged QT and torsades de pointes, the pulmonary embolism right-heart-strain pattern, the broad-complex ventricular tachycardia, and the sodium-channel-blocker wide-QRS with an R-prime in aVR. Includes the ECG-driven drug doses — adenosine 6 mg for SVT, amiodarone 300 mg for VT, magnesium 2 g for torsades, calcium chloride 10 mL of 10% for hyperkalaemia, sodium bicarbonate for TCA toxicity. ACEM-primary, globally tagged.

Checked against its sources on 3 Sept 2026