ACS CPR STEMI 
Dr. Smith's ECG Blog
JULY 25, 2024
They started CPR. Then assume there is ACS. Cardiac arrest #3: ST depression, Is it STEMI? This patient was witnessed by bystanders to collapse. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. sodium bicarbonate.
The Skeptics' Guide to EM
SEPTEMBER 11, 2021
The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. Acute coronary syndrome (ACS) is responsible for the majority (60%) of all OHCAs in patients. EMS arrives and finds the patient in monomorphic ventricular tachycardic (VT) cardiac arrest.
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EMDocs
JANUARY 8, 2024
For patients with OHCA, use of steroids during CPR is of uncertain benefit. Extracorporeal CPR Use of ECPR for patients with cardiac arrest refractory to standard ACLS is reasonable in select patients when provided within an appropriately trained and equipped system of care. COR 2b, LOE B-R. COR 2b, LOE C-LD. COR 2a, LOE B-R.
Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
He reports that this chest pain feels different than prior chest pain when he had his STEMI/OMI, but is unable to further describe chest pain. This is diagnostic of ACS; it appears to be a reperfused acute inferior OMI. Sensitivity was 87% for OMI in our validation study (it was 34% for STEMI criteria). So it can miss some OMI.
Dr. Smith's ECG Blog
OCTOBER 10, 2022
CPR was initiated immediately. If this is ACS with Aslanger's pattern , the ST depression vector of subendocardial ischemia (due to simultaneous 3 vessel or left main ACS) is directed toward lead II (inferior and lateral). It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation.
Dr. Smith's ECG Blog
AUGUST 9, 2019
But if they do present: The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion , though it might be due to sub total LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. All are, however, clearly massive STEMI.
Dr. Smith's ECG Blog
SEPTEMBER 16, 2015
It may be difficult to read STEMI in the setting of RBBB. There is, however, a long QT also, with abnormal T-waves, but this is not STEMI. This ECG was recorded prehospital, and the computer read STEMI, so the medics activated the cath lab: What do you think? The ECG is consistent with high lateral STEMI. Called 911.
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