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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.
emergencydepartments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.
She arrives in the emergencydepartment (ED) with decreased level of consciousness and shock. 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.
This was sent by anonymous The patient is a 55-year-old male who presented to the emergencydepartment after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.
The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). The patient was rushed to the nearest emergencydepartment (non-PCI facility) for stabilization.
She was unable to be defibrillated but was cannulated and placed on ECMO in our EmergencyDepartment (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion.
Below is the version standardized by PM Cardio app Meyers interpretation: Findings are specific for posterior (and also likely inferior) wall transmural acute infarction, most likely due to acute coronary occlusion (OMI). link] ] Outcome The patient emerged neurologically intact. Clinical Cardiology 2019.
Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." She was defibrillated and resuscitated. Such cases are classified as MINOCA (Myocardial Infarction with Non-Obstructed Coronary Arteries). It can only be seen by IVUS.
He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. He arrived in the emergencydepartment hemodynamically stable. The next day, and angiogram showed normal coronary arteries. This young male had ventricular fibrillation during a triathlon. His initial ECG is shown here.
Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen Smith A 61-year-old male with hypertension and hyperlipidemia presented to the emergencydepartment for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. What do you think? Just another NSTEMI.
She was never seen to be in ventricular fibrillation and was never defibrillated. Rather it is due to coronary insufficiency due to a tight left main or 3-vessel disease with inadequate coronary flow. Data collected included demographics, initial rhythm, EKG, emergencydepartment (ED) CT and outcomes.
Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergencydepartment with substernal chest pain for 3 hours prior to arrival. The screening physician ordered an EKG and noted his ashen appearance and moderate distress. Triage EKG: What do you think?
This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST-segment elevations (i.e This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST-segment elevations (i.e
Written by Pendell Meyers A woman in her 70s with known prior coronary artery disease experienced acute chest pain and shortness of breath. She presented to the EmergencyDepartment at around 3.5 She was emergently transferred to a PCI center. KEY Points: DSI does not indicate acute coronary occlusion!
Written by Willy Frick with edits by Ken Grauer An older man with a history of non-ischemic HFrEF s/p CRT and mild coronary artery disease presented with chest pain. The following ECG was obtained in the emergencydepartment during active chest pain. This is the shock coil and identifies this device as a defibrillator.
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