ACS Coronary Epinephrine 
Dr. Smith's ECG Blog
JULY 25, 2024
After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% But cardiac arrest is a period of near zero flow in the coronary arteries and causes SEVERE ischemia. Then assume there is ACS. It also does not uniformly indicate severe coronary disease.
EMDocs
JANUARY 8, 2024
Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). COR 1, LOE B-R. COR 2a, LOE B-R. COR 2a, LOE C-LD.
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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). This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent!
Dr. Smith's ECG Blog
OCTOBER 4, 2010
He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. ACS would be highly unusual in a young athlete, and given the information on his race bib, one must first suspect that the abnormal ST elevation is due to demand ischemia, not ACS. The next day, and angiogram showed normal coronary arteries.
Dr. Smith's ECG Blog
APRIL 2, 2024
I was there and said, "No, I think this is all due to severe chronic cardiomyopathy and cardiac arrest due to primary ventricular fibrillation, not due to ACS." _ Why did I say that? link] __ Case continued There was hypotension, initially controlled with an epinephrine infusion. So we should activate the cath lab, right?
Dr. Smith's ECG Blog
MARCH 1, 2023
In the ED he received methylprednisolone, diphenhydramine, and epinephrine for possible anaphylaxis. Shortly after receiving epinephrine, the patient developed new leg cramps and chest pain. This pattern occurs regardless of whether the cause is ACS (decreased supply) or any other cause of decreased supply or increased demand.
Dr. Smith's ECG Blog
OCTOBER 28, 2013
Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. Here is an article I wrote: Updates on the ECG in ACS. Was this: 1) ACS with ischemia and spontaneous reperfusion? Updates on the Electrocardiogram in Acute Coronary Syndromes.
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