Remove 2022 Remove Cardiac Arrest Remove STEMI
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A man in his 50s with unwitnessed VF arrest, defibrillated to ROSC, and no STEMI criteria on post ROSC ECG. Should he get emergent angiogram?

Dr. Smith's ECG Blog

Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. Despite anticipation by many that the initial post-resuscitation ECG will show an obvious acute infarction — this expected "STEMI picture" is often not seen. 15, 2022 post). As per My Comment in the above-cited Oct.

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ECG Blog #415 — The Cath showed NO Occlusion!

Ken Grauer, MD

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 ).

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50 yo with V fib has ROSC, then these 2 successive ECGs: what is the infarct artery?

Dr. Smith's ECG Blog

This certainly looks like an anterior STEMI (proximal LAD occlusion), with STE and hyperacute T-waves (HATW) in V2-V6 and I and aVL. How do you explain the anterior STEMI(+)OMI immediately after ROSC evolving into posterior OMI 30 minutes later? This caused a type 2 anterior STEMI. The April 8, 2022 post by Drs.

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How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

Subtle as a STEMI." (i.e., 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. None of the 20 ever evolved to STEMI criteria.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

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.

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A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

Dr. Smith's ECG Blog

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.

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75 year old dialysis patient with nausea, vomiting and lightheadedness

Dr. Smith's ECG Blog

This is diagnostic of infero-posterior OMI, but it is falsely negative by STEMI criteria and with falsely negative posterior leads (though they do show mild ST elevation in V4R). They were less likely to have STEMI on ECG, and more likely to be initially diagnosed as non-ACS. Figure-1: The initial ECG in today’s case.