Dr. Smith's ECG Blog

JULY 9, 2024

Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. Meyers and Smith in the October 15, 2022 post of Dr. Smith's ECG Blog ). 15, 2022 post — I like to focus on the ST-T wave appearance in leads V1 and V6 to facilitate recognition of Precordial Swirl. 15, 2022 post).

Defibrillator 116

Defibrillator STEMI Cardiac Arrest Cardiogenic Shock 116

Coronary Artery Disease Journal

OCTOBER 10, 2023

Background Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. Methods We systematically searched PubMed, Embase and Cochrane databases, in June 2022, for randomised controlled trials (RCTs) comparing early versus delayed early CAG. A random effects meta-analysis was performed. 2.40], P = 0.08, I2 = 69%).

Cardiac Arrest 52

Cardiac Arrest Hospital Outcomes 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

He had multiple cardiac arrests with ROSC regained each time. Then there is loss of pulses with continued narrow complex on the monitor ("PEA arrest") Learning Points: Sudden witnessed Cardiac Arrest due to ACS is almost always due to dysrhythmia. This patient arrested shortly after hospital arrival.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Circulation

NOVEMBER 11, 2024

C and hypothermia at 33°C had similar outcomes in out-of-hospital post cardiac arrest patients. In September 2022, we adopted a new temperature control protocol wherein the target temperature was set based on aEEG findings. The median age was 62 years and 105 (66%) patients had cardiac etiology. 2018;22:226).

Cardiac Arrest 40

Cardiac Arrest Hospital Outcomes Circulation 40

Journal of the American Heart Association

DECEMBER 1, 2023

BackgroundEvery year the American Heart Association's Resuscitation Science Symposium (ReSS) brings together a community of international resuscitation science researchers focused on advancing cardiac arrest care.Methods and ResultsThe American Heart Association's ReSS was held in Chicago, Illinois from November 4th to 6th, 2022.

Research 40

Research Cardiac Arrest 40

Ken Grauer, MD

FEBRUARY 3, 2024

Shortly after arrival in the ED ( E mergency D epartment ) — she suffered a cardiac arrest. BUT — Cardiac catheterization done a little later did not reveal any significant stenosis. Figure-1: The initial ECG in today's case — obtained after successful resuscitation from cardiac arrest. ( No CP ( C hest P ain ).

Blog 163

Blog Cardiac Arrest STEMI Plaque 163

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

We periodically review this intriguing ECG finding that is best known for its association with hypothermia — but which may also be seen in association with a number of other entities, including acute infarction and cardiac arrest. My Comment addresses a few additional aspects of this phenomenon.

Blog 138

Blog Cardiac Arrest Atrial Fibrillation Bradycardia 138

Circulation

NOVEMBER 11, 2024

The AAMR declined from 1999 to 2016 (APC -3.0 [-3.3, -2.8]) and rose till 2022 (APC 4.6 [3.4, 17.9]) and NH American Indian or Alaska Native men (1999-2022, APC (-0.6 [-1.6, to 2022, respectively, after an initial decline. to 2022, respectively, after an initial decline. 100000 people). 100000 people).

Cancer 40

Cancer Cardiovascular Disease Cardiac Arrest Heart Disease 40

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. The April 8, 2022 post by Drs. This prompted cath lab activation.

Cardiac Arrest 110

Cardiac Arrest STEMI Ischemia SCAD 110

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? I suspected the answer resides in the reason why an 18-year woman might have a cardiac arrest.

Blog 148

Blog Cardiac Arrest Cardiomyopathy Hospital 148

EMS 12-Lead

MARCH 30, 2024

This false electrical capture may have made cardiac arrest recognition difficult, and the re-arrest may have gone unrecognized for an unknown amount of time. The University of Maryland found that capture occurred in only 42-78% of patients, dependent on pad positioning (Moayedi et al, 2022). Current 85mA.

Cardiac Arrest 124

Cardiac Arrest Pacemaker Pulmonary Bradycardia 124

Dr. Smith's ECG Blog

JUNE 23, 2024

Simply by correlating the history of cardiac arrest with serial ECGs recorded after the event — it became obvious that the 60% lesion on cardiac cath, despite its surprisingly good TIMI 3 flow — was indeed the "culprit" artery that had spontaneously reperfused after the event.

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. First — Some thoughts on the post -resuscitation ECG.

Cardiac Arrest 98

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in extracorporeal cardiopulmonary resuscitation (eCPR) has emerged as a treatment option for selected patients who are experiencing refractory cardiac arrest (CA).

Cardiogenic Shock 64

Cardiogenic Shock Cardiac Arrest BMI Coronary Artery Disease 64

Dr. Smith's ECG Blog

OCTOBER 8, 2024

About 45 minutes after the second EKG, the patient was found in cardiac arrest. Later the next day, she went into cardiac arrest again. By the time I saw the repeat EKG, the patient was already in cardiac arrest. For more on Precordial Swirl — See the October 15, 2022 post in Dr. Smith's ECG Blog ).

Cardiac Arrest 123

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock 123

Society of Thoracic Surgeons - Allied Health

AUGUST 24, 2022

Webinar Arrest after Cardiac Surgery: Is Your Team Ready? kchalko Wed, 08/24/2022 - 08:44 August 18, 2022 During this installment of the STS Webinar Series, an expert panel highlights a team-based approach to managing cardiac surgery patients who suffer sudden postoperative cardiac arrest.

Allied Health 52

Allied Health Webinar Cardiac Arrest Cardiothoracic 52

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. 2022 Jul;27(4):e12939. Epub 2022 Feb 11. Ann Noninvasive Electrocardiol. doi: 10.1111/anec.12939.

Tachycardia 131

Tachycardia Cardiac Arrest ICU Blog 131

ECG Cases

JANUARY 18, 2022

Rob Simard who explains the failings of the ACLS protocol for PEA arrest, how PoCUS pulse checks can help us differentiate true PEA from pseudoPEA, and how to integrate this information and our PoCUS skills into the flow of our cardiac arrest management.

CME 52

CME Cardiac Arrest 52

European Journal of Heart Failure

DECEMBER 13, 2023

Aims Few studies have reported data on the optimal timing of left ventricular (LV) unloading during venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiac arrest or shock. This study evaluated the feasibility of an early LV unloading strategy compared with a conventional strategy in VA-ECMO.

Aortic valve 75

Aortic valve Cardiac Arrest Pulmonary Heart Transplant 75

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

Introduction Sudden cardiac arrest is a major cause of morbidity and mortality worldwide and remains a major public health problem for which better non-invasive prediction tools are needed. All included ACP patients were recruited in 2009 at Yonsei University Hospital and were followed up until 2022. years), 11 patients died.

Chest Pain 64

Chest Pain Cardiac Arrest Public Health Defibrillator 64

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

About an hour later, he was then found on the floor in cardiac arrest in the ED. Sooner identification likely leads to better outcomes, and in this case may have allowed prevention of cardiac arrest and better long-term outcome. His initial troponin T was 15 ng/L (only two hours since pain onset). Plate and Meyers.

Chest Pain 52

Chest Pain Cardiac Arrest Cardiogenic Shock Heart Attack 52

Journal of the American Heart Association

MARCH 21, 2025

However, the association of socioeconomic vulnerability and outcomes after hospitalization is uncertain.Methods and ResultsAmerican Heart Association COVID19 Cardiovascular Disease Registry hospitalizations between March 1, 2020, and June 30, 2022, linked with Medicare feeforservice claims, were analyzed.

COVID-19 40

COVID-19 Medicare Cardiogenic Shock Hospital 40

Journal of Cardiovascular Electrophysiology

DECEMBER 17, 2024

Methods We searched the FDA's Manufacturer and User Facility Device Experience (MAUDE) database for US reports of MACE and device problems that were filed from April 2022 to December 2023 for AVEIR VR, and from June 2022 to April 2024 for Micra VR. The incidences of procedure-related death, cardiac perforation. vs. 24;0.4%; p =.001).

Pacemaker 40

Pacemaker Cardiac Arrest Article 40

Dr. Smith's ECG Blog

DECEMBER 13, 2023

For technical reasons — P waves are not well visible in this tracing — BUT — the P wave in lead I appears to be larger than the P wave in lead II , which is often a tip-off to LA-LL Reversal ( See My Comment in the November 19, 2020 and the May 24, 2022 posts in Dr. Smith's ECG Blog ).

Blog 123

Blog Chest Pain Cardiac Arrest Cardiomyopathy 123

Dr. Smith's ECG Blog

AUGUST 19, 2023

They had had twice the rate of cardiac arrest and twice the in-hospital mortality[1] In another study of patients diagnosed with STEMI, those on dialysis experienced delayed reperfusion and double the mortality.[2] Problem #1: As I emphasized in My Comment in the December 6, 2022 post — Not all patients with acute MI report chest pain.

Chest Pain 98

Chest Pain STEMI Myocardial Infarction Blog 98

Dr. Smith's ECG Blog

JANUARY 8, 2024

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG == MY Comment , by K EN G RAUER, MD ( 12/31 /2023 ): == My only hope about today's tragic case — is that the involved providers learn from mistakes made. I include a summarizing Table of ECG Findings in Figure-2 of the ADDENDUM below ).

Chest Pain 71

Chest Pain Pulmonary Embolism STEMI 71

Circulation: Cardiovascular Quality & Outcomes

JANUARY 5, 2024

Admissions to CICUs with the highest tertile of CCRx utilization had a greater burden of comorbidities, had more diagnoses of ST–elevation myocardial infarction, cardiac arrest, or cardiogenic shock, and had higher Sequential Organ Failure Assessment scores. CCRx was provided to 62.2% (interhospital range of 21.3%–87.1%)

Critical Care 40

Critical Care Cardiogenic Shock Academic Cardiac Arrest 40

Circulation

NOVEMBER 11, 2024

Descriptive data for GWTG-R 2021-2022 metrics identified gaps in guideline adherence and documentation standards: COA 83%, TTS 56%, and survival to discharge 36%. GWTG-R metrics COA, TTS, and survival to discharge were lower than national benchmark and an abundance of resuscitation events were occurring than estimated.

Nursing 40

Nursing COVID-19 Education Document 40

DAIC

JANUARY 23, 2024

mg experienced a 23% lower incidence of death from cardiovascular causes, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina leading to coronary revascularization in a time-to-event analysis. 2022 Sep 6;146(10):e141]. Published 2022 Aug 6. December 22, 2022.

Cardiovascular Disease 111

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease 111

All About Cardiovascular System and Disorders

OCTOBER 25, 2023

But the full cohort of the CABANA trial did not show a significant reduction in the primary composite end point of death, disabling stroke, serious bleeding or cardiac arrest [7]. 2022 Nov 22;146(21):1561-1563. Epub 2022 Nov 21. Cleveland Clinic Journal of Medicine October 2022, 89 (10) 567-571. N Engl J Med.

Atrial Fibrillation 52

Atrial Fibrillation Heart Failure Ablation Cardiac Arrest 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

L/min, BP 107/65 mm Hg, HR 71 bpm LVEF 45%, no wall motion abnormality The patient had a complete neurologic recovery, proving once again that the patient is not dead until he/she is warm and dead. == MY Comment by K EN G RAUER, MD ( 2/8/2022 ): == I thought this to be an intriguing case for a number of reasons.

Cardiac Arrest 40

Cardiac Arrest Bradycardia Chest Pain Ischemia 40

Dr. Smith's ECG Blog

JULY 21, 2024

Meyers and Smith illustrate 20 example cases vs "look-alikes" of Swirl ( with my synthesis of "Swirl" ECG findings in My Comment on that post ) from October 15, 2022. While clearly not needed for diagnosis — today's initial ECG is an instructive tracing in that it illustrates: Precordial " Swirl " — for which Drs.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Stroke Journal

JANUARY 30, 2025

We aim to describe the clinical characteristics, functional status and RT use of PHT Pts with stroke during the PHT admission.Methods:Retrospective cohort study of consecutive PHT Pts at a tertiary center between 09/01/2012 and 09/30/2022. Additionally, 38(45%) were ischemic and 34(40%) were hemorrhagic strokes.Of

Heart Transplant 40

Heart Transplant Transplant Pediatrics Stroke 40

Dr. Smith's ECG Blog

MAY 5, 2022

Steve, what do you think of this ECG in this Cardiac Arrest Patient?" A woman in her 50s with dyspnea and bradycardia A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB). HyperKalemia with Cardiac Arrest. The April 17, 2022 post ( Leads V1,V2 placed too high ).

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

JULY 22, 2023

The reason we continue to periodically review cases of Brugada Phenocopy — is that this entity is still overlooked, as it was in today's case ( See My Comment at the bottom of the page in the May 5, 2022 post — and in the November 25, 2022 post of Dr. Smith's ECG Blog — among other cases of Brugada Phenocopy ).

Chest Pain 92

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography. For more on “My Take” for a systematic approach to ECG interpretation — Please check out My Comment at the bottom of the page in the October 17, 2022 post in Dr. Smith’s ECG Blog.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

Blunt Trauma in a Child 40-something male in a head-on Motor Vehicle Collision and Splenic Injury == MY Comment, by K EN G RAUER, MD ( 10/10 /2022 ): == Highly interesting post by Dr. Smith regarding a 30-something male with multiple injuries from a motor vehicle accident. What are the ECG Findings of Cardiac Contusion?

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52