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He developed cardiacarrest shortly after the ECG in Figure-1 was recorded. Acute myocardial ischemia. Cardiac Sarcoidosis. Primary Cardiac Tumors and/or Cardiac Metastasis. C ASE C onclusion: As noted above — today's patient developed cardiacarrest shortly after arrival in the ED.
Two recent interventions have proven in randomized trials to improve neurologic survival in cardiacarrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation.
There is no definite evidence of acute ischemia. (ie, Simply stated — t he patient was having recurrent PMVT without Q Tc prolongation, and without evidence of ongoing transmural ischemia. ( Some residual ischemia in the infarct border might still be present. Both episodes are initiated by an "R-on-T" phenomenon.
If a patient presents with chest pain and a normal heart rate, or with shockable cardiacarrest, then ischemic appearing ST elevation is STEMI until proven otherwise. In this abstract from 2011, we found that 4%(4 of 99) type 2 MI and 38% of type 1 MI had ST Elevation.
What is the cardiac rhythm shown in the long lead II rhythm strip? Figure-1: The initial ECG in today’s case — obtained from an elderly woman following successful resuscitation from cardiacarrest. ( To improve visualization — I've digitized the original ECG using PMcardio ). What about the 1 2- L ead E CG ?
The patient was unconscious BEFORE the cardiacarrest, at the same time that she had strong pulses. Therefore, cardiacarrest is NOT the etiology of the coma. More cases here to highlight: [link] Middle Aged Woman with Asystolic CardiacArrest, Resuscitated: Cath Lab? OMI is a clinical diagnosis.
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