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Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. However, he did not remember much from the day of the arrest. He did not remember whether he had experienced any chestpain. Lesions less than 70% are generally considered to be non-flow limiting.
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 cardiacarrest: 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
He did not have chestpain. 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 CardiacArrest. Chestpain in high risk patient.
No chestpain. His inpatient clinicians did not think that an urgent angiogram was warranted given that he was chestpain free, his EKG appeared nondiagnostic, and serial troponins were not elevating beyond 2 ug/L. Patients on dialysis often do not have chestpain in the setting of acute MI. Why is this?
He denied any chestpain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. They recommended repeating his ECG and awaiting troponin since the patient did not have any chestpain. Steve, what do you think of this ECG in this CardiacArrest Patient?" What is it?
And she does not know that this is an overdose; she thinks it is a patient with chestpain!! 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
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