Cardiac Arrest, SCAD and STEMI - Cardiovascular Update

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Cardiac Arrest

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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

This certainly looks like an anterior STEMI (proximal LAD occlusion), with STE and hyperacute T-waves (HATW) in V2-V6 and I and aVL. How do you explain the anterior STEMI(+)OMI immediately after ROSC evolving into posterior OMI 30 minutes later? This caused a type 2 anterior STEMI.

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

This is a troponin I level that is almost exclusively seen in STEMI. I suspect this is Type 2 MI due to prolonged severe hypotension from cardiac arrest. So this is either a case of MINOCA, or a case of Type II STEMI. If the arrest was caused by acute MI due to plaque rupture, then the diagnosis is MINOCA.

Defibrillator

Defibrillator Circulation Plaque Cardiac Arrest

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.

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