Remove ACS Remove Coronary Remove ICU
article thumbnail

Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

The patient was upgraded to the ICU for closer monitoring. Electrocardiographic Differentiation Between Acute Pulmonary Embolism and Acute Coronary Syndromes on the Basis of Negative T Waves - ScienceDirect. looked at consecutive patients with PE, ACS, or neither. In fact, Kosuge et al. In fact, Kosuge et al. Kosuge et al.

E-9-1-1 136
article thumbnail

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? Cardioversion will address the rhythm problem immediately, also if the chest discomfort subsides when SR is restored, ischemia from ACS becomes much less likely. In either case, prompt cardioversion is indicated.

professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

A woman in her 50s with acute chest pain

Dr. Smith's ECG Blog

Immediate and early percutaneous coronary intervention in very high-risk and high-risk Non-STEMI patients. Smith comment: We have shown that use of opiates is associated with worse outcomes in ACS: Bracey, A. Opioids in ACS may reduce the pain score, but do not provide reperfusion for ongoing ACS. Lupu L, et al.

ACS 52
article thumbnail

A crashing patient with an abnormal ECG that you must recognize

Dr. Smith's ECG Blog

Wellens pattern is a term which refers to coronary reperfusion morphology in the anterior leads) The best answer is because the entire gestalt of the ECG shows acute right heart strain instead, and just does not look like Wellens after you've seen Wellens hundreds of times. looked at consecutive patients with PE, ACS, or neither.

ACS 52
article thumbnail

A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

Moreover, the Queen is only supposed to be used with a high pretest probability of ACS/OMI. The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Instead — it commonly reflects ischemia from severe underlying coronary disease. Magnesium later resulted at 0.8

Overdose 112
article thumbnail

Inotropes and Vasopressors: Doses, indications, contraindications and effects

ECG & Echo Learning

Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). μg/kg/min + + + ++ Low dose dopamine stimulates D1 receptors and induces vasodilation in coronary, renal, cerebral and mesenteric vessels. Increases coronary blood flow. Coronary flow enhanced.

E-9-1-1 52
article thumbnail

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

Early coronary angiography in post-CA patients with no ST-segment elevation on the presenting ECG may still be of benefit by potentially salvaging myocardium and decreasing the incidence of systolic heart failure in survivors (95.7%, 22/23). Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU.