Dr. Smith's ECG Blog

OCTOBER 4, 2010

An echocardiogram confirmed aortic stenosis with a large pressure gradient. Now there is much less ST segment deviation, less elevation and less depression. The troponin returned positive, and the maximum troponin was 3.8 The next day, and angiogram showed normal coronary arteries. He awoke and did well.

Cardiac Arrest 52

Cardiac Arrest Ischemia Stenosis STEMI 52

Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Formal Echocardiogram: Normal left ventricular size and wall thickness.

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Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Dr. Smith's ECG Blog

JANUARY 2, 2025

See this post: How a pause can cause cardiac arrest 2. In this specific case, Left Bundle Branch (LBB) area pacing was pursued to achieve cardiac resynchronization. There is ventricular bigeminy with bizarre appearing wide T-waves See even more striking cases of this at the bottom of the post. The plan: 1. J Am Coll Cardiol.

Tachycardia 116

Tachycardia Cardiomyopathy Blog Bradycardia 116

Dr. Smith's ECG Blog

JUNE 23, 2024

Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. However, he did not remember much from the day of the arrest. Lesions less than 70% are generally considered to be non-flow limiting. Two subsequent troponins were down trending.

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Frontiers in Cardiovascular Medicine

JUNE 3, 2024

During the intravenous lacosamide infusion, the patient developed sudden cardiac arrest caused by ventricular arrhythmias necessitating resuscitation. Of note, the patient had a family history of sudden cardiac death.

Sudden Cardiac Death 52

Sudden Cardiac Death Coronary Angiogram Cardiac Arrest Laboratory 52

Wellnest

DECEMBER 21, 2022

However, an echocardiogram is a different test, also conducted for heart activity. Cardiac arrest Cardiac arrest is a medical emergency in which the heart stops pumping blood to the body. Electrocardiogram, echocardiogram, and some other tests are done for patients with cardiac arrest.

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Circulation

NOVEMBER 11, 2024

Initial evaluation showed elevated cardiac enzymes (CE) and normal eosinophil count. Transthoracic echocardiogram (TTE) showed an ejection fraction (EF) of 40% and a moderate-large pericardial effusion with signs of tamponade. He had a cardiac arrest during the procedure and was placed back on ECMO.

Myocardial Infarction 40

Myocardial Infarction Coronary Angiogram Echocardiogram Chest Pain 40

Dr. Smith's ECG Blog

APRIL 19, 2012

So don't wait for the laboratory K or you might be resuscitating a cardiac arrest ( see the case with ECGs #3 and #4 of this post ). In this study of consecutive patients with LBBB who were hospitalized and had an echocardiogram , 13% had a QRS duration greater than 170 ms, and only 1% had a duration greater than 190 ms.

Cardiac Arrest 52

Cardiac Arrest Laboratory Echocardiogram Hospital 52

Dr. Smith's ECG Blog

MAY 13, 2017

In any case, the patient needs at a minimum serial ECGs and perhaps a formal echocardiogram. As he was alarmed by it, he went to the patient who now was having recurrent pain, then suddenly went into cardiac arrest (ventricular fibrillation). So, this noise should not be considered TQRSD, and then the formula should not be used.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Myocardial Infarction 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

I think a good start would be a posterior EKG and a high quality contrast echocardiogram read by an expert. Dialysis patients had double the rate of cardiac arrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. 75%), and had an increased odds ratio of death compared to nondialysis patients 1.5 (95%

Chest Pain 52

Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

See this case: what do you think the echocardiogram shows in this case? Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography. POCUS showed good LV-function and no pericardial effusion. The patient had mild but diffuse abdominal tenderness.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

JULY 22, 2023

Formal echocardiogram showed normal EF, no wall motion abnormalities, no pericardial effusion. The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. No more troponins were done. He was found to be influenza positive. 1849 after cath: Brugada pattern is gone!

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Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 92

Dr. Smith's ECG Blog

JULY 27, 2023

hours ECG: Not much change hs troponin I peaks at 500 ng/L 8 hours Next morning Urine drug screen: Amphetamine, Methamphetamine, Fentanyl, Fentanyl metabolite Formal Bubble Contrast Echocardiogram: Indications for Study: Silent Ischemia. SUMMARY Normal left ventricular cavity size. Normal estimated left ventricular ejection fraction.

Tachycardia 52

Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

EMS 12-Lead

JULY 24, 2023

Tortuous LAD consistent with hypertensive cardiac disease and luminal irregularities, but free of stenosis 3. Echocardiogram findings (pre-procedure) 1. Had such been the case, this patient would likely have been a prehospital cardiac arrest, or have been in profound cardiogenic shock at the time of ED arrival.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

An echocardiogram was done. These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Is there also Brugada? Here is the result: The estimated left ventricular ejection fraction is 50 %.

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

It is apparently fortunate that she had a cardiac arrest; otherwise, her ECG would have been ignored. Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. She was defibrillated and resuscitated. I need to innoculate you against the subsequent opinions below.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

I have ordered an echocardiogram which will be done today, after that patient can be discharged to home with follow-up in 2 to 3 months." The echo was normal. Learning points 1. In this regular wide complex tachycardia , since the rhythm converted w adenosine, it is almost certainly SVT w aberrancy, which can be either: A.

Tachycardia 52

Tachycardia Heart Disease Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

DECEMBER 22, 2010

Patients who present with chest pain or cardiac arrest and have an ECG diagnostic of STEMI could have myocardial rupture. In a report of 6 cases at our institution (Hennepin County Medical Center), 2 survived with cardiac surgery. In contrast to re-occlusion of the infarct-related artery, this reversal should be gradual.

Cardiac Arrest 40

Cardiac Arrest Tachycardia STEMI Chest Pain 40

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Smith comment: The patient was lucky to have a cardiac arrest. By undergoing an arrest, providers became aware of his OMI which had not been noticed on his diagnostic ECG, and he thus has a chance at some myocardial salvage. Had he not had one, he would have sat in the waiting room until his entire myocardium at risk infarcted.

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Cardiac Arrest STEMI Blog Ischemia 86

Frontiers in Cardiovascular Medicine

NOVEMBER 28, 2024

In this case, a patient experienced sudden cardiac arrest during sexual activity, which has not previously been reported.Case presentationSix years ago, a 37-year-old man was admitted with sudden cardiac arrest during sexual intercourse. No previous history of hypertension or diabetes.

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Cardiac Arrest Sudden Cardiac Death Electrocardiogram Echocardiogram 45