Before you begin...

This advanced quiz consists of 17 multiple-choice questions and may take up to 90 minutes to complete. The ECGs are kindly provided by Dr Smith's ECG blog, and the questions are significantly more challenging than the beginner, novice, and intermediate quizzes.

The purpose of this quiz is to raise awareness of non-ST-elevation ECG patterns that can, in the right clinical context, be used to identify patients who are in need of emergency treatment.

These ECG patterns are not typically covered by mainstream medical education, and are unlikely to come up in examinations. However, they are of vital importance in clinical practice -- particularly for those who work in the emergency department.

All of the patients in this quiz have chest pain. Some were undergoing occlusive myocardial infarction at the time their ECG was taken. Others had infarcted, but partially reperfused. A third group of patients had critical coronary artery stenosis with high risk of progressing from subendocardial ischaemia to infarction.

Before you get started, we recommend you familiarize yourself with these patterns using our guide.

From Dr. Smith, Dr. Meyers, Dr. McLaren, Dr. Yates, and student Dr. Kahle -- good luck!

When you are ready to begin, hit 'Next' below.