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BACKGROUND:The aim of this study was to examine the impact of early versus delayed catheter-based therapies (CBTs) on clinical outcomes in patients with acute intermediate-risk pulmonary embolism (PE).METHODS:This Secondary outcomes included a composite of 30-day mortality, resuscitated cardiacarrest, and hemodynamic instability.
Smith interpretation: This is highly likely to be due to extreme right heart strain and is nearly diagnostic of pulmonary embolism. What is the clear diagnosis and reason for arrest? It is of course pulmonary embolism. The Queen diagnosed "OMI with high confidence" due to the ST Elevation in V1-V3.
Smith comment: before reading anything else, this case screamed pulmonary embolism to me. CT chest showed left sided pulmonary embolism and a pulmonary infarct that had previously been mistaken for pneumonia. There was 100% proximal LAD occlusion with TIMI 0 flow, and cardiacarrest in the cath lab.
I suspect this is Type 2 MI due to prolonged severe hypotension from cardiacarrest. pulmonary embolism, sepsis, etc.), Coronary thrombosis or embolism can result in MINOCA, either with or without a hypercoagulable state. 24, 2020 post ( link to that post given above ). myocarditis).
It is apparently fortunate that she had a cardiacarrest; otherwise, her ECG would have been ignored. Then they did an MRI: Patient underwent cardiac MRI on 10/4 that showed mildly reduced BiV systolic function. She was defibrillated and resuscitated. Smith: this ECG and clinical presentation is diagnostic of LAD Occlusion.
Cardiac Troponin Testing in Patients with COVID-19: A Strategy for Testing and Reporting Results. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. Guo T, Fan Y, Chen M, et al.
They include myocardial ischemia, acute pericarditis, pulmonary embolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. 2020 Sep;31(9):2474-2483. Spontaneous type 1 ECG has the highest number of points at 3.5, Arch Cardiovasc Dis.
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