ACS Defibrillator STEMI 
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. Cardiac arrest #3: ST depression, Is it STEMI? They started CPR. sodium bicarbonate.
Dr. Smith's ECG Blog
APRIL 24, 2015
Does this patient have ACS? Again, it is common to have an ECG that shows apparent subendocardial ischemia after resuscitation from cardiac arrest, after defibrillation, and after cardioversion. He did not have ACS. We found that 38% of out of hospital ventricular fibrillation was due to STEMI. Learning Points: 1.
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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. Many of these OHCAs are due to ventricular fibrillation or pulseless VT.
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. VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc.
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. On his bib it stated that he had a congenital heart disorder.
EMDocs
JANUARY 8, 2024
With respect to timing, for cardiac arrest with a shockable rhythm, it may be reasonable to administer epinephrine after initial defibrillation attempts have failed. Consider administering epinephrine after defibrillation in those with shockable rhythms. Editorial Comment : Yes to PCI after arrest with STEMI on ECG.
Dr. Smith's ECG Blog
JUNE 19, 2023
This ECG was read as “No STEMI” with no prior available for comparison. It is true this ECG does not meet STEMI criteria (there is 1.0 The Queen of Hearts sees it of course: Still none of these three ECGs meet STEMI criteria. Do you think we discussed this patient's 2-3 hour delay to reperfusion in our quarterly "STEMI meeting"?
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