Remove Cardiac Arrest Remove STEMI Remove Sudden Cardiac Death
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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. So maybe she is better than I am.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Bicarb 20, Lactate 4.2,

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. Twenty-one percent (18 of 88) had a family history of sudden cardiac death and 26.4% (14 of 53) carried a pathogenic SCN5A mutation. And another finding.

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A 50-something man with Chest pain at triage

Dr. Smith's ECG Blog

Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Unexplained sudden cardiac death (3 categories) (+0.5 - +2) 4. Cardiac arrest. Clinical History 2.a. of atrial fib/flutter at age less than 30: +0.5 syncope of unclear etiology: +1 2.c. Suspected arrhythmic syncope: +2 2.d. Hypothermia.