Remove Bradycardia Remove Cardiac Arrest Remove ICU
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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. No other cause of arrest was identified based on lab results or pan-CT scan.

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What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

His temperature was brought back to normal over time in the ICU. C), with Cardiac Echo -- A Pathognomonic ECG. -- Read this ECG -- Osborn Waves and Hypothermia (this is the "Figure" above) What does LBBB look like in severe hypothermia? He was extubated and had normal neurologic function. He did well and was discharged.

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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). Upon arrival in the ICU, before getting Continuous Veno-Venous Hemodialysis (CVVHD), his potassium had risen again to 7.8

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Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

Dr. Smith's ECG Blog

He was admitted to the ICU and transferred emergently to a facility where he could undergo emergent dialysis as a part of further evaluation and management. Steve, what do you think of this ECG in this Cardiac Arrest Patient?" HyperKalemia with Cardiac Arrest. The QRS is narrow and T waves are much less peaked.

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A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest. See these other relevant cases: What are these bizarre bigeminal PVCs?? Is it STEMI?

Ischemia 116
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20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

He was admitted to the ICU and was unstable, in shock, overnight. Case Continued: He was stabilized on more calcium, pressors, and high dose insulin. 3 hours later, this was recorded at a K of 2.8 mEq/L and total calcium of 14.7 mg/dL: The massive ST Elevation persists. What is going on here?