Coronary CPR Epinephrine 
ACEP Now
DECEMBER 6, 2024
A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. During assessment, the patient reported that a left heart catheterization six months prior indicated spasms but no coronary artery disease.
Dr. Smith's ECG Blog
JULY 25, 2024
They started CPR. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% But cardiac arrest is a period of near zero flow in the coronary arteries and causes SEVERE ischemia. It also does not uniformly indicate severe coronary disease.
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EMDocs
JANUARY 8, 2024
Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). COR 1, LOE B-R. COR 2a, LOE B-R. COR 2a, LOE C-LD.
Dr. Smith's ECG Blog
APRIL 2, 2024
There was no bystander CPR. link] __ Case continued There was hypotension, initially controlled with an epinephrine infusion. For this reason we did not believe this was an acute coronary event and did not activate the cath lab. So a dual chamber pacer is placed with one lead through the coronary sinus to the LV.
Dr. Smith's ECG Blog
OCTOBER 28, 2013
It was witnessed, and CPR was performed by trained individuals. Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device.
Dr. Smith's ECG Blog
OCTOBER 20, 2013
Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. With ventilations and epinephrine, she regained a pulse. Rather it is due to coronary insufficiency due to a tight left main or 3-vessel disease with inadequate coronary flow.
Dr. Smith's ECG Blog
APRIL 29, 2020
CPR was started immediately. She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. EMS arrived and found her in a wide complex PEA rhythm.
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