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A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. Recently the rate of true arrhythmic events related to fevers in the classic Brugada Type 1 syndrome was explored by Michowitz et al. There is no further workup at this time.
She was defibrillated and resuscitated. Takotsubo is a sudden event, not one with crescendo angina. Just because you don't see hemodynamically significant CAD on angiogram does not mean it is not OMI. Even in patients whose moderate stenosis undergoes thrombosis, most angiograms show greater than 50% stenosis after the event.
12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC.
I B ECG monitoring should start immediately and a defibrillator must be ready. IIa C During hospital stay (after primary PCI) Either stress echo, CMR, SPECT, or PET may be used to assess myocardial ischaemia and viability, including in multivessel CAD. STEMI , ST-segment elevation acute myocardial infarction ).
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