Remove 2018 Remove Bradycardia Remove Cardiac Arrest
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Normal angiogram one week prior. Must be myocarditis then?

Dr. Smith's ECG Blog

Uncontrolled coronary spasm may be associated with serious arrhythmias , including cardiac arrest ( Looi et al — Postgrad Med, 2012 ; Tan et al — Eur Heart J Case Rep, 2018 ; Chevalier et al — JACC, 1998 ; Rodriguez-Manero — EP Europace, 2018 ). Initial high sensitivity troponin I returned at 6ng/L (normal 0.20

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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

There is sinus bradycardia with one PVC. There is "Shark Fin morphology" I saw this and thought for certain that this was going to be an LAD or left main occlusion as etiology of arrest, and etiology of profound ST Elevation in I, II, aVL, and V3-V6, and ST depression in III, V1 and V2. She then had a 12-lead: What do you think?

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Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ).

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Tachycardia, fever to 105, and ischemic ST Elevation -- a Bridge too Far

Dr. Smith's ECG Blog

If a patient presents with chest pain and a normal heart rate, or with shockable cardiac arrest, then ischemic appearing ST elevation is STEMI until proven otherwise. CLICK HERE — for the ESC/ACC/AHA/WHF 2018 Consensus Document on the 4th Universal Definition of MI, in which these concepts are discussed and illustrated.

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A middle aged man with unwitnessed cardiac arrest

Dr. Smith's ECG Blog

Written by Pendell Meyers, with edits by Steve Smith Thanks to my attending Nic Thompson who superbly led this resuscitation We received a call that a middle aged male in cardiac arrest was 5 minutes out. In 2018 there is generally a delay to onset of dialysis in most EDs. He was estimated to be in his 50s, with no known PMHx.

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Could you have prevented this young man's cardiac arrest?

Dr. Smith's ECG Blog

One hour later (labs not yet returned), here is the ECG recorded just after the team noticed a sudden wide complex with precipitous decompensation, just before cardiac arrest: Bizarre, Brady, and Broad (wide QRS). Unfortunately, this was not recognized at this time. I believe it was this point when hyperkalemia was first suspected.

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A woman in her 50s with dyspnea and bradycardia

Dr. Smith's ECG Blog

Her vital signs were within normal limits except for bradycardia at 55 bpm. It is probably sinus bradycardia with very small/depressed P-waves and prolonged PR interval. See these other related cases: A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB). Is this just right bundle branch block?