Coronary Defibrillator Information 
REBEL EM
JUNE 1, 2023
Indication for emergency invasive coronary angiography or had coronary angiography within 1 hour of arrival. Known obstructive coronary artery disease or known coronary stent. Known cardiac defibrillator. Excluded: Obvious cause for OHCA prior to SDCT or on hospital arrival. Pre-existing DNR order.
Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior. I sent it to 5 of my OMI friends without any clinical information or outcome and all 5 independently responded with exactly the same diagnosis: "reperfused inferior OMI".
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Dr. Smith's ECG Blog
JULY 21, 2024
It shows a proximal LAD occlusion, in conjunction with a subtotally occluded LMCA ( Left Main Coronary Artery ). Upon contrast injection of the LMCA, the patient deteriorated, as the LMCA was severely diseased and flow to all coronary arteries ( LAD, LCx and RCA ) was compromised. He was taken immediately to the cath lab.
Dr. Smith's ECG Blog
OCTOBER 18, 2023
I sent the top ECG to Dr Smith with no information and without the baseline ECG. She spontaneously converted (Defibrillation was not performed). Most such rhythms in the setting of ischemia are VF and will not convert without defibrillation. A repeat magnesium level was not drawn prior to coronary angiography.
Dr. Smith's ECG Blog
OCTOBER 4, 2010
He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. ACS would be highly unusual in a young athlete, and given the information on his race bib, one must first suspect that the abnormal ST elevation is due to demand ischemia, not ACS. The next day, and angiogram showed normal coronary arteries.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
She was defibrillated and resuscitated. Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. One need not have obstructive coronary disease to have occlusive thrombus!
Dr. Smith's ECG Blog
OCTOBER 3, 2017
I sent this ECG with no clinical information to Dr. Smith. The assay at my institution, for example, is frequently negative until 4-6 hours after acute coronary occlusion. After the second defibrillation the patient had an organized rhythm: Bradycardic escape/agonal rhythm, with large ST deviations.
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