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She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. There is sinus bradycardia with one PVC. 2) overlooked obstructive coronarydisease (e.g.,
Similarly, you may use our , app to adjust the paper speed along with amplification to read the slightest changes, especially for conditions like tachycardia and bradycardia. Alternatively, it also helps enhance arrhythmia management with coronaryarterydisease. It improves the prediction model for myocardial scar mass.
After resuscitation and defibrillation , there were no more episodes of TdP. A coronary angiogram was done that did not show significant coronaryarterydisease. Below is the patient’s 12 lead ECG following defibrillation. Echocardiography showed apical ballooning with hypokinesis.
He denied any known medical history, specifically: coronaryarterydisease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Despite immediate chest compressions, and multiple rounds of defibrillation, he could not be resuscitated. No appreciable skin pallor.
She was never defibrillated. Angiogram --Minimal coronary atherosclerosis --No obstructive epicardial coronaryarterydisease or evidence of plaque rupture noted to explain prolonged QT or ventricular fibrillation cardiacarrest, suspect nonischemic mechanism Echo The estimated left ventricular ejection fraction is 45 %.
More past history: hypertension, tobacco use, coronaryarterydisease with two vessel PCI to the right coronaryartery and circumflex artery several years prior. VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc. He reports feeling nauseated with emesis.
He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.
The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronaryarterydisease with supply/demand mismatch). The arrhythmia spontaneously converted before defibrillation was achieved.
Within ten minutes, she developed bradycardia, hypotension, and ST changes on monitor. Bradycardia and heart block are very common in RCA OMI. Several 200 J shocks did not terminate the VF, so a second defibrillator was applied for double sequential defibrillation with 400 J. She was defibrillated perhaps 25 times.
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