Remove CAD Remove Coronary Remove CPR
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1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

ECMO Flow was achieved after approximately 1 hour of high quality CPR. Angiography showed normal coronaries. MINOCA: Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease). Here is my comment on MINOCA: "Non-obstructive coronary disease" does not necessarily imply "no plaque rupture with thrombus."

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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

His daughter immediately started CPR and another family member called EMS. The patient was treated as possible NSTEMI and underwent coronary angiography about 4 hours after presentation. TIMI 3 means the rate of passage of dye through the coronary artery is normal by angiography.) Initial hsTnI was 384 ng/L.

Coronary 111
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How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" Furthermore, among 35 patients with acute left main coronary artery occlusion, 9 presented with RBBB (mostly with LAFB) on the admission ECG.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

CPR was initiated immediately. As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow).

ACS 52
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PseudoSTEMI and True ST elevation in Right Bundle Branch Block (RBBB). Don't miss case 4 at the bottom.

Dr. Smith's ECG Blog

A middle-aged male with h/o CAD and stents presented with typical chest pressure. Is there likely to be fixed coronary stenosis that led to demand ischemia during pneumonia? --Was Furthermore, among 35 patients with acute left main coronary artery occlusion, 9 presented with RBBB (mostly with LAFB) on the admission ECG.

STEMI 52
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Fascinating case of dynamic shark fin morphology - what is going on?

Dr. Smith's ECG Blog

In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. The patient was transferred immediately for angiogram which revealed no significant CAD, and no intervention was performed. Coronary spasm causing massive current of injury with shark fin ECG. I suspect LAD or LM.