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He underwent coronary stenting (uncertain which artery). An emergency cardiacultrasound could be very useful. Appreciation of these subtle ECG findings could have helped to avoid a cardiacarrest and its resulting permanent disability 3. I do not have the post-resuscitation ECG. Could this have been avoided?
We present the case of a man in his 50s, admitted with cardiacarrest secondary to inferolateral STEMI. Successful PPCI was performed via right femoral artery, with access gained under ultrasound guidance. The patient recovered successfully and was discharged two weeks later.
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?
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. 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 He appeared to be in shock.
A middle-aged male with h/o CAD and stents presented with typical chest pressure. A bedside ultrasound was done by the emergency physician, using Speckle Tracking. A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. This is a very common misread. The trick is to find the end of the QRS.
He had a previous MI with cardiacarrest 2 years prior. It was opened and stented. There was an old ECG for comparison: One year prior with no ST segment abnormalities A bedside cardiacultrasound was done by the emergency physician. Culprit, stented) 3. A stent was placed and the patient became pain free.
His ED cardiacultrasound (which is not at all ideal for detecting wall motion abnormalities, and is also very operator dependent for this finding) was significant for depressed global EF. It was thought to be an in stent restenosis and thrombosis from a DES placed in the same region 6 months prior.
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