Cardiac Arrest, Defibrillator and Stenosis

Guidelines would (erroneously) say that this patient who was defibrillated and resuscitated does not need emergent angiography

Dr. Smith's ECG Blog

JUNE 27, 2024

A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. This is FAR LESS than all other studies of shockable arrest. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. It will be staged later on this admission. See my discussion at the bottom. --And

Defibrillator

Defibrillator Cardiac Arrest STEMI Chest Pain

Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. Why?

Dr. Smith's ECG Blog

APRIL 24, 2015

ST depression is common BOTH after resuscitation from cardiac arrest and during atrial fib with RVR. Again, it is common to have an ECG that shows apparent subendocardial ischemia after resuscitation from cardiac arrest, after defibrillation, and after cardioversion. The patient was cardioverted. This was done.

Cardiac Arrest

Cardiac Arrest Defibrillator Atrial Fibrillation Ischemia

Case Report: Extended cardiopulmonary resuscitation in sudden cardiac arrest after acute myocardial infarction

Frontiers in Cardiovascular Medicine

AUGUST 8, 2024

Out-of-hospital cardiac arrest (OHCA) mostly occurs in crowded public places outside hospitals, such as public sports facilities, airports, railway stations, subway stations, and shopping malls. Fortunately, there was no obvious stenosis in the right coronary artery.

Cardiac Arrest

Cardiac Arrest Myocardial Infarction Coronary Artery Bypass Graft Stenosis

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Defibrillator Positioning; PFA for PVC Ablation; Harvey Weinstein's Heart Surgery

Med Page Today

SEPTEMBER 10, 2024

(MedPage Today) -- Not all defibrillator pad positions may work equally well for patients with shockable out-of-hospital cardiac arrest. JAMA Network Open) Medical therapy for aortic stenosis? Early clinical data on evogliptin were disappointing.

Defibrillator

Defibrillator Cardiac Arrest Ablation Stenosis

Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Dr. Smith's ECG Blog

OCTOBER 28, 2013

She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest.

Cardiac Arrest

Cardiac Arrest Ischemia Defibrillator Electrocardiogram

Cardiac Arrest, acute ST elevation and depression superimposed on LVH, but NOT due to ACS

Dr. Smith's ECG Blog

OCTOBER 4, 2010

He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. An echocardiogram confirmed aortic stenosis with a large pressure gradient. This young male had ventricular fibrillation during a triathlon. On his bib it stated that he had a congenital heart disorder. His initial ECG is shown here.

Cardiac Arrest

Cardiac Arrest Ischemia Stenosis STEMI

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

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

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?

Cardiac Arrest

Cardiac Arrest STEMI Ischemia SCAD

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

Dr. Smith's ECG Blog

MAY 19, 2020

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.

Defibrillator

Defibrillator Circulation Plaque Cardiac Arrest

Right Bundle Branch Block with Acute ST Elevation Seen Best on Prehospital ECG

Dr. Smith's ECG Blog

FEBRUARY 25, 2009

The patient had 2 ventricular fibrillation arrests during transport, but was immediately defibrillated both times, and was awake in the ED, when the following ECG was recorded: The ST elevation has mostly resolved on this ECG, and were it not for the arrest and the prehospital ECG, this would not be a slam dunk diagnosis.

Cardiac Arrest

Cardiac Arrest Chest Pain Defibrillator STEMI

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

JULY 21, 2024

Angiography : LMCA — 90-99% osteal stenosis. LCx — 50-69% stenosis of the 1st marginal branch; with 100% distal LCx occlusion. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation.

Arrhythmia

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The arrhythmia spontaneously converted before defibrillation was achieved. This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest.

Cardiogenic Shock

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest

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

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.

Plaque

Plaque Chest Pain Thrombosis Stenosis

See what happens when hyperacute T-waves are missed

Dr. Smith's ECG Blog

SEPTEMBER 20, 2018

In the ambulance during transport, the patient suddenly suffered VF arrest. He was defibrillated immediately and had return of normal mental status. Given the VF arrest during transport, however, they appropriately all agreed that cath should happen sooner rather than later. They took him almost immediately for catheterization.

Chest Pain

Chest Pain STEMI Cardiac Arrest Aneurysm

Cardiovascular Update

Guidelines would (erroneously) say that this patient who was defibrillated and resuscitated does not need emergent angiography

Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. Why?

Case Report: Extended cardiopulmonary resuscitation in sudden cardiac arrest after acute myocardial infarction

Webinars

Defibrillator Positioning; PFA for PVC Ablation; Harvey Weinstein's Heart Surgery

Cardiac arrest: even after the angiogram, the diagnosis is not always clear

Cardiac Arrest, acute ST elevation and depression superimposed on LVH, but NOT due to ACS

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

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

Right Bundle Branch Block with Acute ST Elevation Seen Best on Prehospital ECG

What are treatment options for this rhythm, when all else fails?

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

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

See what happens when hyperacute T-waves are missed

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