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And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis.
After resuscitation and defibrillation , there were no more episodes of TdP. A coronaryangiogram was done that did not show significant coronary artery disease. Below is the patient’s 12 lead ECG following defibrillation. The patient was diagnosed with stress cardiomyopathy. What does this ECG tell you?
We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. Indeed, bedside Echocardiogram revealed severe left ventricular impairment of Takotsubo cardiomyopathy. The coronaryangiogram revealed no critical stenosis, or acute plaque ulceration. References Chiale, P.
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