Remove Cardiac Arrest Remove ICU Remove Stent
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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. See the following management algorithm: In other words, if this arrest is determined to have been due to acute coronary syndrome, the patient can be monitored without the immediate need for ICD implantation.

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How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

About 45 minutes after the second EKG, the patient was found in cardiac arrest. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. She could not be resuscitated.

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A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments

Dr. Smith's ECG Blog

It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior. Fortunately, he was extubated several days later in the ICU with intact baseline mental status and was discharged shortly thereafter to subacute rehab. His troponin I peaked at 97 ng/mL (very large MI!).