Cardiac Arrest, Chest Pain and Echocardiogram

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

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. Formal Echocardiogram: Normal left ventricular size and wall thickness.

Cardiac Arrest

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter

Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report

Circulation

NOVEMBER 11, 2024

Case presentation:A 64-year-old man presented with one day of chest pain. Initial evaluation showed elevated cardiac enzymes (CE) and normal eosinophil count. Transthoracic echocardiogram (TTE) showed an ejection fraction (EF) of 40% and a moderate-large pericardial effusion with signs of tamponade.

Myocardial Infarction

Myocardial Infarction Coronary Angiogram Echocardiogram Chest Pain

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chest pain. A mid 60s woman with history of hypertension, hyperlipidemia, and GERD called 911 for chest pain. It is also NOT the clinical scenario of takotsubo (a week of intermittent chest pain).

Plaque

Plaque Chest Pain Thrombosis Stenosis

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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

NOVEMBER 4, 2022

The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. See this case: what do you think the echocardiogram shows in this case?

Ischemia

Ischemia STEMI Stenosis Chest Pain

Critical Left Main

EMS 12-Lead

JULY 24, 2023

But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chest pain was a little more intense, and the needed recovery period was longer in duration. Tortuous LAD consistent with hypertensive cardiac disease and luminal irregularities, but free of stenosis 3.

Angina

Angina Ischemia Coronary Angiogram Stenosis

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

The pneumothorax was expanded with a chest tube At 17 hours, another ECG was recorded: It is now much less dramatic and has the morphology of Type 2 Brugada The hs troponin I peaked at 6500 ng/L -- this strongly suggests myocardial contusion. An echocardiogram was done. Is there also Brugada? Right ventricular prominence.

Arrhythmia

Arrhythmia Blog Chest Pain Cardiac Arrest

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

JUNE 23, 2024

Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. However, he did not remember much from the day of the arrest. He did not remember whether he had experienced any chest pain. Two subsequent troponins were down trending.

Chest Pain

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

OCTOBER 31, 2024

Chest X-Ray A chest X-ray is often the first imaging test conducted, as it can reveal whether the heart is enlarged and by how much. Echocardiogram An echocardiogram uses sound waves to produce a detailed image of the heart, allowing doctors to see the size of the heart chambers and how well the heart is pumping blood.

Blood Pressure

Blood Pressure Blood Clot Heart Valves Heart Rhythm

An intoxicated, agitated, 29 year old with chest pain

Dr. Smith's ECG Blog

MAY 13, 2017

He complained of severe chest pain and was extremely agitated, so much so that he was throwing chairs in triage. Some time later, reperfusion T-waves developed (analogous to Wellens' waves): Case 3 Here is a case of a 30-something otherwise healthy male with chest pain: There is neither an S-wave nor J-wave in lead V3.

Chest Pain

Chest Pain STEMI Cardiac Arrest Myocardial Infarction

Why is ECG machine use? What diseases can EKG monitor detect?

Wellnest

DECEMBER 21, 2022

However, an echocardiogram is a different test, also conducted for heart activity. If you experience any symptoms, such as chest pain, dizziness, unusual tiredness or fatigue, shortness of breath, or irregular heartbeat, your doctor would want you to go for an ECG test to find out the underlying cause.

Cardiac Arrest

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

JULY 22, 2023

Written by Pendell Meyers A man in his 70s with no cardiac history presented with acute weakness, syncope, and fever. He denied chest pain or shortness of breath. In the clinical context of weakness and fever, without chest pain or shortness of breath, the likelihood of Brugada pattern is obviously much higher.

Chest Pain

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia

A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

No chest pain. I think a good start would be a posterior EKG and a high quality contrast echocardiogram read by an expert. His inpatient clinicians did not think that an urgent angiogram was warranted given that he was chest pain free, his EKG appeared nondiagnostic, and serial troponins were not elevating beyond 2 ug/L.

Chest Pain

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. It was from a patient with chest pain: Note the obvious Brugada pattern. The Troponin I was cycled over time and was 0.353 followed by 0.296. This patient ruled out for MI.

Heart Rhythm

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI

Cardiac Arrest, hypotension, tachycardia

Dr. Smith's ECG Blog

DECEMBER 22, 2010

Patients who present with chest pain or cardiac arrest and have an ECG diagnostic of STEMI could have myocardial rupture. In a report of 6 cases at our institution (Hennepin County Medical Center), 2 survived with cardiac surgery. Obviously, administration of heparin and/or lytics is hazardous.

Cardiac Arrest

Cardiac Arrest Tachycardia STEMI Chest Pain

Sometimes a patient is fortunate to have a cardiac arrest

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Written by Pendell Meyers A man in his 60s presented with acute chest pain. Smith comment: The patient was lucky to have a cardiac arrest. By undergoing an arrest, providers became aware of his OMI which had not been noticed on his diagnostic ECG, and he thus has a chance at some myocardial salvage.

Cardiac Arrest

Cardiac Arrest STEMI Blog Ischemia

Cardiovascular Update

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

Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

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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?

Critical Left Main

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

An intoxicated, agitated, 29 year old with chest pain

Why is ECG machine use? What diseases can EKG monitor detect?

A man in his 70s with weakness and syncope

A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Hyperthermia and ST Elevation

Cardiac Arrest, hypotension, tachycardia

Sometimes a patient is fortunate to have a cardiac arrest

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