Cardiac Arrest and Plaque - Cardiovascular Update

ECG Blog #415 — The Cath showed NO Occlusion!

Ken Grauer, MD

FEBRUARY 3, 2024

Shortly after arrival in the ED ( E mergency D epartment ) — she suffered a cardiac arrest. BUT — Cardiac catheterization done a little later did not reveal any significant stenosis. Figure-1: The initial ECG in today's case — obtained after successful resuscitation from cardiac arrest. ( No CP ( C hest P ain ).

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Blog Cardiac Arrest STEMI Plaque

Cardiac arrest, LBBB with STEMI on the ECG, but no Acute Coronary Syndrome!

Dr. Smith's ECG Blog

SEPTEMBER 20, 2011

This 80 year old with a history of CABG had a cardiac arrest. Now, it is true that shortly after a non-ACS cardiac arrest, there can be transient diffuse ST depression, but not ST elevation in a coronary distribution, and there should not be a wall motion abnormality. This is as clear a STEMI as you can get.

Cardiac Arrest

Cardiac Arrest STEMI Ultrasound Chest Pain

Cardiac Arrest. What does the ECG show? Also see the bizarre Bigeminy.

Dr. Smith's ECG Blog

APRIL 29, 2020

A 60-something woman presented after a witnessed cardiac arrest. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. Final Diagnosis: Cardiac Arrest due to Torsades from long QT of unknown etiology.

Cardiac Arrest

Cardiac Arrest Defibrillator Ischemia Tachycardia

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

Dr. Smith's ECG Blog

MAY 19, 2020

I suspect this is Type 2 MI due to prolonged severe hypotension from cardiac arrest. The Type 2 MI would then have been a result of the prolonged severe shock while in arrest. If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA. FFR can be useful. What is Type 2 MI?

Defibrillator

Defibrillator Circulation Plaque Cardiac Arrest

The Hidden Toll of Chronic Stress on Your Heart Health

MIBHS

JULY 31, 2024

While many arrhythmias are harmless, some can be life-threatening and increase your risk of stroke, heart failure, and sudden cardiac arrest. Sustained inflammation can damage your blood vessels, leading to atherosclerosis (plaque buildup) and increasing your risk of heart attack and stroke.

Blood Pressure

Blood Pressure Heart Attack Heart attacks Heart Rhythm

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

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. To prove there is no plaque rupture, you need to do intravascular ultrasound (IVUS).

Plaque

Plaque Chest Pain Thrombosis Stenosis

Understanding the Difference Between Heart Attack and Cardiac Arrest

MIBHS

MARCH 31, 2025

When discussing heart health, heart attacks and cardiac arrest are two terms that are often mistaken for one another. Understanding the difference between heart attack and cardiac arrest can help in recognizing symptoms, seeking prompt medical care, and even saving lives. What is Cardiac Arrest?

Cardiac Arrest

Cardiac Arrest Heart Attack Heart attacks Chest Pain

Critical Left Main

EMS 12-Lead

JULY 24, 2023

Category 1 : Sudden narrowing of a coronary artery due to ACS (plaque rupture with thrombosis and/or downstream showering of platelet-fibrin aggregates. elevated BP), but rather directly correlated with coronary obstruction (due to plaque rupture and thrombosis) and, potentially, stymied TIMI flow. This results in Type I MI.

Angina

Angina Ischemia Coronary Angiogram Stenosis

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Thirty-six patients (36%) presented with cardiac arrest, and 78% (28/36) underwent emergent angiography. Subendocardial Ischemia from another Cause ( ie, sustained tachyarrhythmia; cardiac arrest; shock/profound hypotension; GI bleeding; anemia; "sick patient"; etc. ).

Ischemia

Ischemia STEMI Stenosis Chest Pain

ECG with Aslanger's Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.

Dr. Smith's ECG Blog

JANUARY 4, 2021

The patient was subsequently given 5000 units of heparin, 180 mg of ticagrelor, and defib pads were placed on the patient in the event that he should have a cardiac arrest. Angiogram Culprit Lesion: 90% mid LAD stenosis with evidence of plaque rupture, TIMI III flow on angiography.

Ischemia

Ischemia Pulmonary STEMI Chest Pain

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

OCTOBER 31, 2024

Coronary Artery Disease (CAD) CAD, which involves the narrowing or blockage of coronary arteries due to plaque buildup, can reduce blood flow to the heart. Cardiac Arrest or Sudden Death: Cardiomegaly increases the risk of life-threatening arrhythmias, which can cause sudden cardiac arrest.

Blood Pressure

Blood Pressure Blood Clot Heart Valves Heart Rhythm

The Role of Genetics in Heart Disease: Can You Prevent It?

MIBHS

FEBRUARY 28, 2025

Specific genetic variants, such as those affecting cholesterol metabolism, can increase the likelihood of plaque buildup in the arteries. Arrhythmias: Genetic mutations can also predispose individuals to irregular heart rhythms, such as atrial fibrillation or long QT syndrome, which may increase the risk of stroke or sudden cardiac arrest.

Genetic predisposition

Genetic predisposition Heart Disease Cholesterol Blood Pressure

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

OCTOBER 10, 2022

As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow). He had multiple cardiac arrests with ROSC regained each time.

Cardiac Arrest

Cardiac Arrest Chest Pain Embolism Pulmonary

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

JUNE 23, 2024

His ECG at the accepting facility is shown below: Accepting facility ECG The team reviewed his angiography films with an interventionalist and thought they were suspicious for plaque rupture in LAD, but they were not confident. Frick — "Angiography can be misleading — and must always be understood in clinical context".

Chest Pain

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog

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

Dr. Smith's ECG Blog

OCTOBER 20, 2024

There are multiple possible clinical situations that could account for diffuse subendocardial ischemia that is not due to ACS and plaque rupture. This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Unless some LMCA flow is restored he will not survive.

Cardiogenic Shock

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest

Why is ECG machine use? What diseases can EKG monitor detect?

Wellnest

DECEMBER 21, 2022

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. If the vital organs do not get their blood supply back quickly, it can lead to death.

Cardiac Arrest

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

DAIC

JANUARY 23, 2024

Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes of disability and death worldwide.1,2 alone, more than 800,000 of these people are at risk of MI and for approximately 200,000 of them, this may well be their second life-threatening cardiac event. 4 In the U.S.

Cardiovascular Disease

Cardiovascular Disease Heart Attack Heart attacks Coronary Artery Disease

ECG Blog #415 — The Cath showed NO Occlusion!

Cardiac arrest, LBBB with STEMI on the ECG, but no Acute Coronary Syndrome!

Cardiac Arrest. What does the ECG show? Also see the bizarre Bigeminy.

Webinars

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

The Hidden Toll of Chronic Stress on Your Heart Health

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

Understanding the Difference Between Heart Attack and Cardiac Arrest

Critical Left Main

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

ECG with Aslanger's Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

The Role of Genetics in Heart Disease: Can You Prevent It?

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

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.

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

Why is ECG machine use? What diseases can EKG monitor detect?

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

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