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He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. l/min cardiac output. There was no bystander CPR.
Although one may have all kinds of ischemic findings as a result of cardiacarrest (rather than cause of cardiacarrest), 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?
Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates. See this post: How a pause can cause cardiacarrest 2. She was intubated. The plan: 1. Place temporary pacemaker 3. Discontinue amiodarone, since it prolongs the QT 4.
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.
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 cardiacarrest with return of spontaneous circulation. She was successfully revived after several rounds of ACLS including defibrillation and amiodarone.
Photo by Cedars-Sinai milla1cf Fri, 03/01/2024 - 08:25 March 1, 2024 — Two new studies by Cedars-Sinai investigators support using artificial intelligence (AI) to predict sudden cardiacarrest-a health emergency that in 90% of cases leads to death within minutes. It cannot be treated with a defibrillator and often leads to death.
Chronic Pulmonary Disease Lung diseases like chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension, which in turn can cause the right side of the heart to enlarge, a condition known as cor pulmonale. Implantable Cardioverter-Defibrillator (ICD) to help manage dangerous heart rhythms.
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 false electrical capture may have made cardiacarrest 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. On ED arrival ROSC is achieved.
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 cardiacarrest 30 years ago presented with shortness of breath and left leg swelling.
February 2024 FDA Approvals: Innovations in Cardiovascular Interventions XACT Carotid Stent System (Approved: 02/07/2024) This approval expands the indications to be used during a Transcarotid Artery Revascularization (TCAR) procedure to prevent future strokes.
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. If cardiacarrest from hypokalemia is imminent (i.e.,
CASTLE-AF randomized 363 patients with atrial fibrillation and left ventricular ejection fraction of 35% or less, NYHA class II-IV heart failure and having an implanted defibrillator to either catheter ablation or medical therapy with rate or rhythm control [5]. Among the subjects of CABANA trial 35% had NYHA class above II at baseline.
We rapidly defibrillated her, and with return of normal sinus rhythm. Several minutes later the patient developed V-fib again > 200J defibrillation with return to NSR. Rapid sequence intubation was performed for airway protection in setting of recurrent V-fib and defibrillations. Chest X-ray also showed pulmonary edema.
The patient was unconscious BEFORE the cardiacarrest, at the same time that she had strong pulses. Therefore, cardiacarrest is NOT the etiology of the coma. she had severe pulmonary edema. More cases here to highlight: [link] Middle Aged Woman with Asystolic CardiacArrest, Resuscitated: Cath Lab?
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