Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. She was successfully revived after several rounds of ACLS including defibrillation and amiodarone.

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Tachycardia Cardiac Arrest ICU Blood Pressure 123

Dr. Smith's ECG Blog

DECEMBER 23, 2014

None of these findings are diagnostic of ischemia, but they should give you a high index of suspicion and prompt serial ECGs at a minimum. The patient was diagnosed with esophageal reflux and was being discharged by the nurse when he had a cardiac arrest. He was defibrillated. Ischemia comes and goes.

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia STEMI 52

Dr. Smith's ECG Blog

APRIL 29, 2020

A 60-something woman presented after a witnessed cardiac arrest. She was never defibrillated. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. Cardiac cath showed minimal disease. She recovered.

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Cardiac Arrest Defibrillator Ischemia Tachycardia 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. In terms of ischemia, there is both a signal of subendocardial ischemia (STD max in V5-V6 with reciprocal STE in aVR) AND a signal of transmural infarction of the inferior wall with Q wave and STE in lead III with reciprocal STD in I and aVL.

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Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

MAY 6, 2019

Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chest pain for the ischemia and potential syncope for brugada. Ischemia/infarction. Cardioversion/defibrillation.

Chest Pain 52

Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

OCTOBER 26, 2020

Case submitted by Magnus Nossen MD from Norway, written by Pendell Meyers A man in his 50s with no pertinent medical history suffered a witnessed cardiac arrest. 12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC.

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Ischemia Arrhythmia Defibrillator Chest Pain 52

Ken Grauer, MD

MARCH 23, 2023

She underwent cardiopulmonary resuscitation for VT/VFib — with ROSC ( R eturn O f S pontaneous C irculation ) following defibrillation and treatment with Epinephrine and Amiodarone. A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure-1.

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Blog Tachycardia Arrhythmia Atrial Flutter 78

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. Perhaps the bifascicular block ( RBBB/LPHB ) present on ECG #1 — but which resolved by ECG #2 — was also ischemic-related from the cardiac arrest.

Cardiac Arrest 52

Cardiac Arrest Bradycardia Chest Pain Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 3, 2017

After the second defibrillation the patient had an organized rhythm: Bradycardic escape/agonal rhythm, with large ST deviations. This means that they occur shortly after onset of occlusion, but also may be the last remaining sign of ischemia after ST elevation resolves (after reperfusion).

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Chest Pain STEMI Defibrillator Stents 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

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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Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

In addition to a spontaneous or induced Brugada-1 ECG pattern, criteria for B rugada S yndrome require one or more of the following: History of cardiac arrest, of polymorphoic VT, or of non-vagal syncope — positive family history of sudden death at an early age — a similar ECG in close relatives.

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52