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He underwent coronary stenting (uncertain which artery). Appreciation of these subtle ECG findings could have helped to avoid a cardiacarrest and its resulting permanent disability 3. He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. Could this have been avoided?
Cardiacarrest can cause diffuse subendocardial ischemia, usually transient (it often resolves as time goes by after ROSC). It was stented. Also, anterior MI could result from 1) ACS, but also from 2) severe ischemia due to combination of a hemodynamically significant LAD stenosis + severe hypotension during cardiacarrest.
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.
Pressors were required, and the patient was transported to the cath lab with a door to balloon time of 60 minutes, where a proximal dominant RCA occlusion was opened and stented. Normal saline bolus was given, with improvement in BP. She underwent therapeutic hypothermia, and emerged from coma.
About 45 minutes after the second EKG, the patient was found in cardiacarrest. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. Later the next day, she went into cardiacarrest again. She was worked as a full code, and ROSC was achieved.
In 2012, she had a ventricular fibrillation cardiacarrest. The superior limb of the baffle was stenosed and required stenting. In 1973 she underwent a Mustard operation, switching atrial blood flow using a baffle, which was complicated by complete heart block. An epicardial pacemaker was implanted.
We present the case of a man in his 50s, admitted with cardiacarrest secondary to inferolateral STEMI. Additional arterial access via left brachial artery was obtained, and a covered stent was deployed successfully in the right femoral artery with satisfactory haemostasis.
A stent was placed, and the patient had an excellent outcome with no wall motion abnormality. Were it not for this prehospital ECG and the cardiacarrest, the diagnosis may have been significantly delayed. Were it not for this prehospital ECG and the cardiacarrest, the diagnosis may have been significantly delayed.
A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiacarrest with unrecognized STEMI, died. EMS recorded the following ECG: What do you see?
About an hour later, he was then found on the floor in cardiacarrest in the ED. He was taken to the cath lab where he was found to have acute total occlusion of his saphenous vein graft to his RCA, which was stented. QUESTIONS: About 1 hour after ECG #1 was done — the patient was found on the floor in the ED in cardiacarrest.
IntroductionThe 2015 American Heart Association Guidelines recommended mechanical thrombectomy with stent‐retriever devices. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.
But the lack of traditional Sgarbossa criteria is not reassuring enough for such high pretest probability (elderly patient with chest pain, out of hospital cardiacarrest and LBBB), and the Modified Sgarbossa Criteria confirms Occlusion MI in this case. So the RCA was stented. Any indications for cath lab activation?
This was stented. If cardiacarrest from hypokalemia is imminent (i.e., As I indicated above, in our cardiacarrest case, after pushing 40 mEq, the K only went up to 4.2 The mean serum potassium level was lower after resuscitation from cardiacarrest (3.6 The patient stabilized. mEq/L, from 1.9
February 2024 FDA Approvals: Innovations in Cardiovascular Interventions XACT Carotid Stent System (Approved: 02/07/2024) This approval expands the indications to be used during a Transcarotid Artery Revascularization (TCAR) procedure to prevent future strokes.
A middle-aged male with h/o CAD and stents presented with typical chest pressure. A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiacarrest with unrecognized STEMI, died.
The patient was referred immediately for cath which revealed RCA occlusion that was stented. Smith: This bizarre ECG looks like a post cardiacarrest ECG with probable acidosis or hyperkalemia in addition to OMI. There is some down sloping ST-segment and T wave inversion in lead aVL. How did the Queen of Heart AI model perform?
They found an acute lesion of the LAD at the site of the prior stents, including 70% proximal LAD lesion and 95% mid-LAD stenosis with TIMI 3 flow at the time of cath. The LAD lesion was acute and required 3 stents to restore flow. They took him almost immediately for catheterization.
He had a previous MI with cardiacarrest 2 years prior. It was opened and stented. Culprit, stented) 3. A stent was placed and the patient became pain free. Down below are 3 more cases and a discussion of how to differentiate false positive isolated STE in aVL from True positive. He was clammy and looked unwell.
The patient was taken back to the cath lab, where 100% proximal in-stent rethrombosis was found and treated. This is diagnostic of re-occlusion. This ECG cannot be present 7 days after a single persistent acute occlusion. Repeat ECG after PCI: LAD occlusion resolving.
It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior. Dialysis patients had double the rate of cardiacarrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. 75%), and had an increased odds ratio of death compared to nondialysis patients 1.5 (95%
Smith comment: The patient was lucky to have a cardiacarrest. By undergoing an arrest, providers became aware of his OMI which had not been noticed on his diagnostic ECG, and he thus has a chance at some myocardial salvage. Total proximal LAD occlusion was found and stented at angiography soon after the ECG above.
He had undergone stenting of the LAD several weeks ago (unclear whether elective for stable symptoms, or in response to acute coronary syndrome). Plus recommendations from a 5-member panel on cardiacarrest. Written by Pendell Meyers An adult man presented with acute chest pain. He appeared critically ill. That ( as per Dr.
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