Dr. Smith's ECG Blog
MAY 19, 2020
ECMO Flow was achieved after approximately 1 hour of high quality CPR. Diagnosis of MINOCA should be made according to the Fourth Universal Definition of MI, in the absence of obstructive coronary artery disease (CAD) (no lesion ≥50%). After good ECMO flow was established, she was successfully defibrillated. myocarditis).
Dr. Smith's ECG Blog
JUNE 23, 2024
His daughter immediately started CPR and another family member called EMS. Stated differently, the differential diagnosis for the presenting syndrome was either ventricular fibrillation due to acute coronary syndrome, or idiopathic ventricular fibrillation and bystander stable CAD.
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Dr. Smith's ECG Blog
OCTOBER 10, 2022
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).
Dr. Smith's ECG Blog
SEPTEMBER 16, 2015
A middle-aged male with h/o CAD and stents presented with typical chest pressure. Here is his ECG: The resident was alarmed at the "ST elevation in III with reciprocal ST depression in aVL" Are you alarmed? This is a very common misread. It may be difficult to read STEMI in the setting of RBBB. The trick is to find the end of the QRS.
Dr. Smith's ECG Blog
AUGUST 9, 2019
Here is another proven left main occlusion in a young woman who presented with sudden pulmonary edema, had this ECG recorded, then arrested and was resuscitated after 30 minutes of CPR: This has sinus tachycardia with RBBB and LAFB, and STE in V2-V6 as well as I, aVL This pattern could just as easily be seen in LAD occlusion.
Dr. Smith's ECG Blog
OCTOBER 26, 2020
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. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC.
Dr. Smith's ECG Blog
APRIL 8, 2016
He had significant history of CAD with CABG x5, and repeat CABG x 2 as well as a subsequent PCI of the graft to the RCA (twice) and of the graft to the Diagonal. A late middle-aged man presented with one hour of chest pain. Most recent echo showed EF of 60%. He also had a history of chronic kidney disease, stage III.
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