Remove Cardiac Arrest Remove Defibrillator Remove Embolism
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Abstract 4139677: A rare case of ventriculobronchial fistula caused by an epicardial defibrillator patch

Circulation

Background:Epicardial patch defibrillators (EPDs) were commonly implanted in the 1990s for secondary prevention of sudden cardiac death. This case highlights such a scenario.Case:A 75-year-old female with a history of cardiac arrest 30 years ago presented with shortness of breath and left leg swelling.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). CPR was initiated immediately. This is a quiz.

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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

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. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion. The K was normal.

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Transcutaneous Pacing: Part I

EMS 12-Lead

This false electrical capture may have made cardiac arrest recognition difficult, and the re-arrest may have gone unrecognized for an unknown amount of time. The receiving staff suspects pulmonary embolism due to S1Q3T3 on the ECG and administers TPA. They are unable to feel a pulse and resume CPR.

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50 yo with V fib has ROSC, then these 2 successive ECGs: what is the infarct artery?

Dr. Smith's ECG Blog

Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?

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

MIBHS

Implantable Cardioverter-Defibrillator (ICD) to help manage dangerous heart rhythms. Blood Clots: An enlarged heart is more prone to developing blood clots, which can lead to stroke or pulmonary embolism. Coronary Artery Bypass Surgery for those with blocked arteries, improving blood flow to the heart muscle.

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

Dr. Smith's ECG Blog

She was defibrillated and resuscitated. It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored. Then they did an MRI: Patient underwent cardiac MRI on 10/4 that showed mildly reduced BiV systolic function. I need to innoculate you against the subsequent opinions below.

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