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Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Dr. Smith's ECG Blog

Cardiac arrest can cause diffuse subendocardial ischemia, usually transient (it often resolves as time goes by after ROSC). Also, anterior MI could result from 1) ACS, but also from 2) severe ischemia due to combination of a hemodynamically significant LAD stenosis + severe hypotension during cardiac arrest.

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Another Inadequate Paper Published on Triage ECGs, whose Conclusions Need Scrutiny.

Dr. Smith's ECG Blog

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. Given the dire consequences of missing a STEMI or OMI, including cardiac arrest (see cases below), $5700 is extremely cheap. This paper was just published: Noll S. Am J Emerg Med 36(10):1771-1774. October 2018.

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A portable ECG device! Upgrade your traditional device.

Wellnest

This makes it possible for medical professionals to monitor the rhythm of the heart and detect any anomalies that could point to a cardiac problem being present. In this blog post, learn more about the advantages of a portable ECG device and how it can change how you track your heart health.

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. All electrocardiograms (ECGs) and coronary angiograms were blindly analyzed by experienced cardiologists. Harhash AA, Huang JJ, Reddy S, et al. aVR ST segment elevation: acute STEMI or not?

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Circulation, 117, 1890–1893. [3]: Brugada electrocardiographic pattern induced by fever.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Figure-1: ECG criteria for diagnosis of a Brugada-1 or Brugada-2 pattern ( See text ). == N OTE : There are numerous additional cases regarding Brugada pattern ECGs by Dr. Smith on this blog ( Simply search for Brugada Syndrome! ).

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. We repeated the ECG: Brugada pattern is mostly resolved. Follow up the next AM: Brugada pattern is resolved Below is what the electrophysiologist recommended. 8, 2019 ) — ( Jan.