2019 Coronary Defibrillator 
Dr. Smith's ECG Blog
JUNE 27, 2024
A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. The proof of this is that only 5% of patients enrolled had acute coronary occlusion. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. This study failed to do so. 5% vs. 58%!! As per Dr.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). The arrhythmia spontaneously converted before defibrillation was achieved. This is an ominous sign.
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The Skeptics' Guide to EM
SEPTEMBER 11, 2021
Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). Acute coronary syndrome (ACS) is responsible for the majority (60%) of all OHCAs in patients. Lemke et al 2019 published a multicentre RCT done in the Netherlands looking at patients without ST se.
Dr. Smith's ECG Blog
JULY 21, 2024
It shows a proximal LAD occlusion, in conjunction with a subtotally occluded LMCA ( Left Main Coronary Artery ). Upon contrast injection of the LMCA, the patient deteriorated, as the LMCA was severely diseased and flow to all coronary arteries ( LAD, LCx and RCA ) was compromised. He was taken immediately to the cath lab.
Dr. Smith's ECG Blog
JUNE 21, 2023
Below is the version standardized by PM Cardio app Meyers interpretation: Findings are specific for posterior (and also likely inferior) wall transmural acute infarction, most likely due to acute coronary occlusion (OMI). Clinical Cardiology 2019. The LCX was noted to be "subtotally stenosed" at the time of cath.
Dr. Smith's ECG Blog
JUNE 14, 2024
He underwent coronary angiography which showed severe multivessel disease, and he agreed to proceed with workup for CABG. But artifact is "alive and well" — and learning to recognize it will amaze many of your colleagues ( and may serve to avoid an unnecessary defibrillation or two ). The August 26, 2019 post — baseline artifact.
EMS 12-Lead
AUGUST 22, 2022
We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. The coronary angiogram revealed no critical stenosis, or acute plaque ulceration. Paradoxically, though, the third green arrow identifies a QRS that is more narrow than the RBBB complexes surrounding it. 40, 1234-41. Larsen, T.
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