Remove Coronary Remove OR Remove Overdose
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20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

A 20-something presented after a huge verapamil overdose in cardiogenic shock. And she does not know that this is an overdose; she thinks it is a patient with chest pain!! Comment on High Dose Insulin and Calcium Channel Blocker Overdose I do not have any explanation for the ST-T abnormalities here. The initial K was 3.0

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ECG Cases 47 – ECG Interpretation in Toxicology

Emergency Medicine Cases

ST/T changes: consider the differential including demand ischemia, associated electrolyte abnormalities, Brugada pattern from sodium channel blockade, and acute coronary occlusion vs vasospasm from cocaine. The post ECG Cases 47 – ECG Interpretation in Toxicology appeared first on Emergency Medicine Cases.

Coronary 239
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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. Top 10 Take Home Pearls 1.

Naloxone 115
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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

But cardiac arrest is a period of near zero flow in the coronary arteries and causes SEVERE ischemia. Smith's ECG Blog ( See My Comment in the March 1, 2023 post) — DSI does not indicate acute coronary occlusion! It also does not uniformly indicate severe coronary disease. The ECG shows severe ischemia, possibly posterior OMI.

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Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Dr. Smith's ECG Blog

The 50-something patient with history of coronary stenting and slightly reduced LV ejection fraction. which would suggest reduced rates of major adverse cardiac events with coronary artery bypass grafting." On the other hand, stable EKG over an hour in the setting of ongoing acute coronary syndrome is again unusual.

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2023 AHA Update on ACLS

EMDocs

Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Major Updates Avoid routine use of calcium in patients with cardiac arrest. COR 2a, LOE B-R. COR 2a, LOE C-LD. COR 2b, LOE B-R. COR 2b, LOE B-R. COR 3, No benefit, LOE B-R.

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

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.