ACS Defibrillator Definition 
Dr. Smith's ECG Blog
JULY 25, 2024
He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. Then assume there is ACS. See these related cases: Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. This patient was witnessed by bystanders to collapse. They started CPR. sodium bicarbonate.
Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
This is diagnostic of ACS; it appears to be a reperfused acute inferior OMI. VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc. Suppose the OMI had been recognized, or suppose another ECG had been recorded and it showed definite OMI. In aVF it is "coved" (upwardly convex).
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Dr. Smith's ECG Blog
OCTOBER 28, 2013
She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest. References : 1.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. She was defibrillated and resuscitated. Most studies examine undifferentiated ACS cohorts, with only a handful providing separate data. References: 1.
Dr. Smith's ECG Blog
SEPTEMBER 21, 2020
He was found in ventricular fibrillation and defibrillated, then brought to a local ED which does not have a cath lab. He was treated medically for ACS and did not get an angiogram within 72 hours. The 4th universal definition mentions ST depression, posterior MI, and T-wave changes." And we wouldn't do it tomorrow either."
Dr. Smith's ECG Blog
DECEMBER 31, 2024
But thankfully, when the clinical context is clearly and highly concerning for ongoing ischemia from ACS, this distinction doesn't matter much. Soon after the witnessed occlusion, the patient suffered ventricular fibrillation arrest, from which he was immediately resuscitated with 1 defibrillation.
Dr. Smith's ECG Blog
DECEMBER 27, 2024
After ruling out for ACS, the patient underwent angiography where he was found to have severe stable disease, which was already known. The reality is that definitive diagnosis of VT is not nearly as difficult when the rate of the WCT rhythm is not overly fast. This demands an explanation -- sepsis, hemorrhage, withdrawal, etc.
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