Dr. Smith's ECG Blog
MAY 26, 2023
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
Emergency Medicine Cases
DECEMBER 20, 2023
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.
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Dr. Smith's ECG Blog
JULY 25, 2024
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. And what do you want to do?
EMDocs
NOVEMBER 6, 2023
Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. It is reasonable to administer vasodilators (eg, nitrates, phentolamine, calcium channel blockers) for patients with cocaine-induced coronary vasospasm or hypertensive emergencies. COR 2a, LOE C-LD. COR 2a, LOE C-LD. COR No Benefit, LOE C-LD.
EMDocs
JANUARY 8, 2024
Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Independent of a patient’s neurologic status, coronary angiography is reasonable in all post–cardiac arrest patients for whom coronary angiography is otherwise indicated.
Dr. Smith's ECG Blog
NOVEMBER 1, 2022
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.
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.
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