Remove Cardiac Arrest Remove Myocardial Infarction Remove Ultrasound
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Case Report: Extended cardiopulmonary resuscitation in sudden cardiac arrest after acute myocardial infarction

Frontiers in Cardiovascular Medicine

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. ECMO support therapy for patients with cardiac arrest can be considered when economic conditions permit.

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Missed myocardial infarction with subsequent cardiac arrest

Dr. Smith's ECG Blog

An emergency cardiac ultrasound could be very useful. Appreciation of these subtle ECG findings could have helped to avoid a cardiac arrest and its resulting permanent disability 3. The upright portion of the T-wave in aVF is very large compared to the QRS size. If these remain unchanged, then serial troponins.

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Extreme shock and cardiac arrest in COVID patient

Dr. Smith's ECG Blog

A bedside cardiac ultrasound was normal, with no effusion. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. Myocardial Infarction Type 2 and Myocardial Injury.

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Brachial artery approach for managing retroperitoneal bleed following coronary intervention for STEMI

The British Journal of Cardiology

Primary percutaneous coronary intervention (PPCI) remains the gold-standard treatment for ST-elevation myocardial infarction (STEMI). We present the case of a man in his 50s, admitted with cardiac arrest secondary to inferolateral STEMI.

STEMI 52
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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. If cardiac arrest from hypokalemia is imminent (i.e., As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 He was managed medically with Clopidogrel.

STEMI 52
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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

In this case, profound shock for 1 hour would result in the same degree of infarction. I suspect this is Type 2 MI due to prolonged severe hypotension from cardiac arrest. A followup ECG was recorded 2 days later: No definite evidence of infarction. This is a troponin I level that is almost exclusively seen in STEMI.

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

Dr. Smith's ECG Blog

Troponin T peaked at 38,398 ng/L ( = a very large myocardial infarction, but not massive-- thanks to the pre-PCI spontaneous reperfusion, and rapid internvention!! ). Another approach is sympathetic chain (stellate ganglion) blockade if you have the skills to do it: it requires some expertise and ultrasound guidance.